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 of the neuromuscular junction; the roles of postsynaptic acetylcholine receptors and voltage-gated Na+ channels and in converting the chemical signal from the nerve terminal into a propagated action potential on the muscle fiber that triggers muscle contraction; the safety factor for neuromuscular transmission; and how the safety factor is reduced in different forms of autoimmune myasthenia gravis.
journal_name
Neurol Clinjournal_title
Neurologic clinicsauthors
Ruff RL,Lisak RPdoi
10.1016/j.ncl.2018.01.001subject
Has Abstractpub_date
2018-05-01 00:00:00pages
275-291issue
2eissn
0733-8619issn
1557-9875pii
S0733-8619(18)30001-Xjournal_volume
36pub_type
杂志文章,评审abstract::The author defines lacunes, classifies types of lacunes and their causes, discusses the correlation between lacunes and specific syndromes, and suggests appropriate therapy. ...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:
更新日期:1983-02-01 00:00:00
abstract::The neurologic manifestations of gastrointestinal disease are generally thought to be uncommon, although an increasing number of previously unidentified associations are being established. These neurologic disorders may result from nutritional or non-nutritional causes. In the absence of clear malnutrition, it is like...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1989-08-01 00:00:00
abstract::Throughout pregnancy and the puerperium, a variety of hormonal and physiologic changes occur that are associated with pregnancy-specific neurologic conditions, which may also influence known preexisting medical conditions or bring previously unknown neurologic conditions to clinical attention. This article reviews the...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2012.06.003
更新日期:2012-08-01 00:00:00
abstract::Brain metastases are a common complication of cancer and alter patient management more than metastases at any other site of distant progression. Supportive therapies include steroids and antiseizure medications. Definitive treatments include radiation therapy, surgery, and chemotherapy. The optimal choice of treatment...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2007.07.011
更新日期:2007-11-01 00:00:00
abstract::Glycogen is a crucial source of energy in the initial stages of muscle activity and during exercise of high intensity. There are 10 well-defined biochemical defects of glycogen metabolism expressed in muscle and affecting the following enzymes: alpha 1,4 glucosidase (glycogenesis type II), debrancher enzyme (III), bra...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1989-02-01 00:00:00
abstract::Traumatic injury to the posterior fossa is a complex pathologic condition because of the great heterogeneity of lesions present. Treatment of primary brain injuries and prevention of secondary brain injuries is the mainstay of management. It is imperative to recognize traumatic lesions of the posterior fossa early bec...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2014.07.010
更新日期:2014-11-01 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::Sports-related concussions (SRCs) are common among athletes in the United States. Most athletes who sustain an SRC recover within 7 to 10 days; however, many athletes who sustain the injury do not recover as expected and experience prolonged, persistent symptoms. In this document, the authors provide an overview of th...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2017.03.008
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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::Neurologically critically ill patients, more often than others, are unable to communicate and, for a crucial period of time, have the vital functions of their brains hidden in the "black box" of the cranial vault behind a curtain of ambiguity and immobility. Customarily--and naively--we have relied upon beside clinica...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1995-08-01 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::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::Infantile spasms are a seizure disorder in young infants with diverse etiologies, suggesting that they arise from any disturbance of central nervous system function during susceptible periods of development. The prognosis for normal intellectual and neurologic development parallels that of the underlying etiology. Ear...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1990-08-01 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::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::The vasculitides are diseases characterized by inflammation of blood vessels and inflammatory leukocytes in vessel walls. There is an increased propensity for ischemic stroke, resulting from compromise of vessel lumina with distal tissue ischemia; and hemorrhagic or nonhemorrhagic stroke, and aneurysmal formation and ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2019.01.004
更新日期:2019-05-01 00:00:00
abstract::Psychogenic movement disorders (PMDs) can present with varied phenomenology that may resemble organic movement disorders. The diagnosis is based on clinical evaluation with a supporting history and classic features on neurologic examination. Ancillary testing, such as imaging and neurophysiologic studies, can provide ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2014.09.013
更新日期:2015-02-01 00:00:00
abstract::The criteria that characterize restless legs syndrome (RLS) and the differential diagnoses are discussed. Clinical signs include sleep disturbance, involuntary movements in sleep or wakefulness, a normal neurologic examination, a chronic clinical course, and, in some cases, a positive family history. Periodic limb mov...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70277-2
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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 ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1995-02-01 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::SEPs may be recorded over the spine and scalp to stimulation of any accessible mixed or sensory nerve in the extremities. SEP abnormalities are useful in detecting lesions in central somatosensory pathways. They do not establish a specific diagnosis, but they may suggest or support a diagnosis made on clinical grounds...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1988-11-01 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::Most CNS fungal infections can be divided into those that occur in normal hosts and those that occur in the immunosuppressed host. Cryptococcal infection, however, is common in both groups. The usual clinical presentation of a CNS fungal infection is chronic headache and mental status change. The CSF shows a lymphocyt...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1986-02-01 00:00:00
abstract::The term thoracic outlet syndromes, is a group designation for several distinct disorders (one of questionable validity) involving various components of the brachial plexus, the blood vessels, or both, at various points between the base of the neck and the axilla. Four of the five subgroups (true neurologic TOS, arter...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70149-3
更新日期:1999-08-01 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::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::In summary, PET and SPECT are versatile imaging modalities capable of providing dynamic information regarding the metabolism and physiology of brain and brain tumor. PET and SPECT are useful adjuncts to MRI and CT scanning in the important clinical areas of presurgical estimations of tumor grade. In addition, PET can ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1991-05-01 00:00:00
abstract::A recently described syndrome, disabling positional vertigo (DPV), is characterized by persistent and progressive vertigo that is always associated with nausea and occasionally with vomiting; symptoms are made worse with changes in head position and are lessened with bedrest. Patients with DPV have abnormal results on...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1990-05-01 00:00:00
abstract::A network of family-based community-oriented primary health programs, or Programa Agentes Communita˙rios de Saúde, and family health programs, or Programa Saúde da Família, introduced almost 2 decades ago were the Brazilian government's health care models to restructure primary care under the Unified Health System, or...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2016.06.002
更新日期:2016-11-01 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