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 criteria for diagnosis include elevated serum muscle enzymes, myopathic features on EMG, and muscle biopsy abnormalities, including muscle fiber necrosis, degeneration, and inflammatory infiltrates. Inclusion body myositis is distinctive in that distal weakness is most commonly equal to or greater than proximal weakness and muscle biopsy reveals rimmed, cytoplasmic vacuoles, eosinophilic inclusions in the cytoplasm, and nucleus and abnormal filamentous structures. Autoimmune mechanisms seem likely to be involved in the pathogenesis of these disorders and viral infection may be etiologically involved in some of these diseases. The differences in the site of immune-mediated damages suggest an angiography in dermatomyositis while direct muscle fiber involvement is more likely in polymyositis and inclusion body myositis. Therapy of these disorders is similar although some, particularly inclusion body myositis, may be particularly resistant to therapy. Prednisone is currently recommended as the first treatment with azathioprine or methotrexate added after 3 months if steroids are ineffective.
journal_name
Neurol Clinjournal_title
Neurologic clinicsauthors
Kingston WJ,Moxley RT 3rdsubject
Has Abstractpub_date
1988-08-01 00:00:00pages
545-61issue
3eissn
0733-8619issn
1557-9875journal_volume
6pub_type
杂志文章,评审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::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::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::Myasthenia gravis (MG) is an antibody-mediated muscle disease in which any skeletal muscle can be affected. MG may produce numerous symptoms and signs. To doctors and patients, it may seem like lung disease, stroke, heart disease, or the effects of emotional stress. This article explores the "territory" between MG and...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-05-01 00:00:00
abstract::The nosology of dementia has evolved from the simple distinctions between senility, degenerative dementia, and vascular insults that existed a few decades ago. The differentiation of normal cognitive aging from very mild dementia has sharpened considerably; however, appreciation of the heterogeneity of Alzheimer's dis...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70225-5
更新日期:2000-11-01 00:00:00
abstract::The past 40 years have seen the evolution of acute ischemic stroke management from unproven therapies du jour, such as steroids, heparin for stroke in evolution, and hypervolemic-hemodilution, to more of a scientific basis for our decision-making process. This evolution is directly related to the advancements in imagi...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2011.09.014
更新日期:2012-02-01 00:00:00
abstract::Vasculitis or angiitis refers to a group of inflammatory disorders of the blood vessels that cause structural damage to the affected vessel, including thickening and weakening of the vessel wall, narrowing of its lumen, and, usually, vascular necrosis. Systemic vasculitis is classified according to the vessel size and...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2009.09.015
更新日期:2010-02-01 00:00:00
abstract::The etiology of pyogenic infections of the brain and meninges varies principally by age, predisposing causes or conditions, and anatomic site of the infection. An appreciation of these factors, plus the prudent use of noninvasive anatomic diagnostic techniques (such as CT) and examination of the CSF, will provide a ba...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:
更新日期:1986-02-01 00:00:00
abstract::The evaluation and treatment of spinal cord injury continues to evolve, enhanced by new imaging modalities. Their application in reference to the cervical, thoracic, and lumbar spine is discussed. Treatment options, both conservative and surgical, are outlined. ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-08-01 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::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::Botulinum toxin therapy has emerged as a treatment modality for a variety of spastic- or contracture-related muscle diseases. Its safety has been proven for long-term use in the treatment of benign essential blepharospasm, hemifacial spasm, and certain types of strabismus. Recent approval from the Federal Drug Adminis...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-02-01 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::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 ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-11-01 00:00:00
abstract::Legal issues must be considered in caring for patients with epilepsy. Doctors caring for people with epilepsy may be legally involved in three primary ways: as the agent of social control, as patient advocate, and as the target of liability or malpractice suits. This article examines these factors and the implications...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
abstract::Smartphones make mobile computing at point of care practical. Smartphones can think, sync, and link. Built-in and user-installed applications facilitate communications between neurologists and their medical colleagues and patients and augment data acquisition and processing in the core medical information domains of p...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:10.1016/j.ncl.2009.11.001
更新日期:2010-05-01 00:00:00
abstract::The dysphagia of ALS is characterized by an impaired oral stage of swallowing, which has a direct impact on the seemingly more robust pharyngeal stage. Increased duration of the volitional stage (PPRT) of swallowing, including DT and lingual motility deficits, appear to be the major contributors to the dysphagia. The ...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:
更新日期:1987-05-01 00:00:00
abstract::The nervous system is involved in approximately 25% of patients with classical Wegener's granulomatosis. The spectrum of this disease has been broadened with the discovery of the anti-neutrophil cytoplasmic antibodies, which are found in diseases sharing many clinical features. The ANCA testing may indicate a common m...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70353-4
更新日期:1997-11-01 00:00:00
abstract::Tuberous sclerosis is a multisystem disorder characterized by changes primarily involving the skin, eye, and central nervous system. Although the disease often produces mental retardation and seizures, this is not universal, and some patients with tuberous sclerosis lead a relatively normal life. ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1987-08-01 00:00:00
abstract::The oldest-old represent the fastest growing segment of society, and the risk of developing dementia continues to increase with advancing age into the 9th and 10th decades of life. The most common form of dementia in the oldest-old is Alzheimer disease (AD), although there are often mixed pathologies contributing to d...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2017.01.006
更新日期:2017-05-01 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::Diagnostic testing is of limited value among patients with migraine who present to an emergency department. Various nonopioid, disease-specific treatments are available for patients who present to an emergency department with migraine headache and associated features. Emergency physicians should recognize that the acu...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2019.07.005
更新日期:2019-11-01 00:00:00
abstract::In patients with TIA or ischemic stroke of noncardiac origin antiplatelet drugs are able to decrease the risk of stroke by 11-15%, and the risk of stroke, MI, and vascular death by 15-22%, but not mortality. Low doses of aspirin (50-325 mg) are as effective as high doses and cause less gastrointestinal side effects. S...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70196-1
更新日期:2000-05-01 00:00:00
abstract::MS has certain salient morphologic features that distinguish it from other disorders of white matter and that may represent points of departure for investigation. ...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:
更新日期:1983-08-01 00:00:00
abstract::The diagnostic approach to the patient with cancer with suspected CNS infection depends on an analysis of the patient's immune defect, the time course of development of manifestations of infection, and the type of clinical syndrome with supportive evidence for a specific diagnosis coming from laboratory and neuroradio...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(02)00075-0
更新日期:2003-02-01 00:00:00
abstract::Personal experience indicates we sleep differently when sick. Data reviewed demonstrate the extent to which sleep is altered during the course of infection of host organisms by several classes of pathogens. One important unanswered question is whether or not the alterations in sleep during infection are of functional ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2006.03.002
更新日期:2006-08-01 00:00:00
abstract::Transcranial Doppler ultrasonography (TCD) is a noninvasive, bedside, portable tool for assessment of cerebral hemodynamics. Modern TCD head frames allow continuous hands-free emboli detection for risk stratification and assessment of treatment efficacy in several cardiovascular diseases. Identifying a focal stenosis,...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2019.09.006
更新日期:2020-02-01 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 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::Neuroepidemiology is the application of the methods of epidemiology to the problems of clinical neurology. After diagnosis, the most basic characterization of a disease is its frequency. This characterization requires ascertainment of case (numerator) within their population at risk (denominator) to provide incidence,...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70255-3
更新日期:1996-05-01 00:00:00