Abstract:
:Sleep medicine can be a particularly rewarding clinical area for neurologists. After all, the driving organ of sleep is the brain. Many of the sleep disorders are primary brain disorders, whereas other sleep disorders (and their medications) influence brain function. But without an organized approach, even the engaged and motivated neurologist can easily become frustrated when dealing with patients whose concerns center on an undesirable degree of sleepiness. Lost in the thicket of information provided during the patient-doctor encounter, many physicians are unable to direct the history toward particular diagnostic hypotheses. So, rather than provide an exhaustive and disorganized set of details about sleep medicine, the author instead shares pearls of sleep medicine in the context of an overall framework, with the goal to foster targeted history-taking for the successful diagnosis of a patient struggling with maintaining wakefulness. The topic of excessive sleepiness will be covered because it is so common and because its mastery is fundamental to approaching most patients with sleep disorders. Common and important pitfalls regarding the topic of sleepiness-and how to avoid them-will be discussed. Misdiagnoses and mismanagement are easy to avoid if this entire framework is kept in mind.
journal_name
Semin Neuroljournal_title
Seminars in neurologyauthors
Ellenbogen JMdoi
10.1055/s-0036-1586264subject
Has Abstractpub_date
2016-10-01 00:00:00pages
449-455issue
5eissn
0271-8235issn
1098-9021journal_volume
36pub_type
杂志文章,评审abstract::Neurotoxic venoms are common among tropical marine creatures, which have specialized apparatuses for delivery of the venoms. These include jellyfish and anemones, venomous cone snails, venomous fish, stingrays, sea snakes, and venomous octopuses. Numerous toxic neuropeptides are found within these venoms, and some can...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2005-917664
更新日期:2005-09-01 00:00:00
abstract::Headaches are a common complaint for most women during their lifetime, including gestation and puerperium. Tension-type headaches and migraine flare-ups are the most common headache complications after delivery, but the differential diagnosis of postpartum headache is broad. The clinician must distinguish common heada...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1293537
更新日期:2011-09-01 00:00:00
abstract::Obstructive sleep apnea (OSA) is a very common condition in patients with stroke and is found in over half of stroke patients. There is a complex relationship between OSA and stroke, attributable to shared risk factors. There are numerous mechanisms by which OSA may contribute to increased stroke risk, including promo...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2006-933315
更新日期:2006-02-01 00:00:00
abstract::Psychogenic (nonepileptic) seizures are among the most common and serious of all psychogenic neurological disorders. They account for approximately 20% of all intractable seizure disorders referred to comprehensive epilepsy centers and present with a reported annual incidence of approximately 4% that of true epilepsy....
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-2006-945520
更新日期:2006-07-01 00:00:00
abstract::Improved disease control is critical for enhancing the lives of those living with multiple sclerosis. With specific immunologic targets, monoclonal antibody (mAb) treatments are highly effective options for relapsing forms of multiple sclerosis. The mechanism, efficacy, and current safety profiles are detailed for the...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1579695
更新日期:2016-04-01 00:00:00
abstract::With the advent of combination antiretroviral therapies, the mortality rate from HIV has declined, while the prevalence of long-term HIV-related neurologic complications continues to rise. Thirty-six million individuals are living with HIV around the world, many of whom reside in resource-limited settings. The majorit...
journal_title:Seminars in neurology
pub_type: 杂志文章
doi:10.1055/s-0038-1649334
更新日期:2018-04-01 00:00:00
abstract::The clinical evaluation of peripheral neuropathies can be challenging. This article presents an approach based on a structured assessment that asks a series of yes or no questions during the history and examination that leads to localization and characterization of the neuropathy. The final assessment includes further...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2005-871323
更新日期:2005-06-01 00:00:00
abstract::Cognitive complaints are common in any adult neurology practice, and may present in a variety of ways other than classic "memory loss." In this article, the author reviews a simple approach to a symptom-based differential diagnosis, including recognition of impairment in several key cognitive domains as well as associ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1271314
更新日期:2011-02-01 00:00:00
abstract::The muscular dystrophies are disorders of progressive muscular degeneration and weakness. As a group they display clinical heterogeneity that reflects the heterogeneity of molecular mechanisms responsible for them, and range from congenital to adulthood onset. Recent advances in the field include improved methods of d...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1329199
更新日期:2012-07-01 00:00:00
abstract::Autoimmune epilepsy is increasingly recognized as a distinct clinical entity, driven in large part by the recent discovery of neural autoantibodies in patients with isolated or predominant epilepsy presentations. Detection of neural autoantibodies in high-risk epilepsy patients supports an immune-mediated cause of sei...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1660860
更新日期:2018-06-01 00:00:00
abstract::Besides sleep apnea, the main disorders of excessive daytime sleepiness include narcolepsy and hypersomnia. Narcolepsy is characterized by periods of irresistible sleepiness and sleep attacks of brief duration and, most often, by one or more of the auxiliary symptoms: cataplexy, sleep paralysis, and hypnogogic halluci...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1041425
更新日期:1987-09-01 00:00:00
abstract::Emery-Dreifuss muscular dystrophy (EDMD) is the third most common X-linked muscular dystrophy. This disorder is characterized by childhood onset of early contractures, humeroperoneal muscle atrophy, and cardiac conduction abnormalities. Weakness is slowly progressive, but there is a broad spectrum of clinical severity...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1040827
更新日期:1999-01-01 00:00:00
abstract::Fungal central nervous system infections present in a myriad of clinical manifestation and remain a significant diagnostic challenge. Presenting symptoms, cerebrospinal fluid analysis, conventional fungal serum markers and imaging correlates of disease are seldom sensitive or specific; fungal culture growth or histopa...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1688916
更新日期:2019-06-01 00:00:00
abstract::Excessive daytime sleepiness (EDS) or somnolence is common in our patients and in society in general. The most common cause of EDS is "voluntary" sleep restriction. Other common causes include sleep-fragmenting disorders such as the obstructive sleep apnea syndrome. Somewhat less familiar to the clinician are EDS cond...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2004-835069
更新日期:2004-09-01 00:00:00
abstract::Despite decades of basic and clinical research, treatments to improve outcomes after traumatic brain injury (TBI) are limited. However, based on the recent recognition of the prevalence of mild TBI, and its potential link to neurodegenerative disease, many new and exciting secondary injury mechanisms have been identif...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1544237
更新日期:2015-02-01 00:00:00
abstract::The human genome has become a roadmap for elucidation of the pathophysiology of disease. It is likely that mutations in more than 1000 of the approximately 30,000 human genes will lead to autonomic abnormalities, either directly or indirectly. This review highlights some of these, which exert major effects on catechol...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2004-817723
更新日期:2003-12-01 00:00:00
abstract::Carotid endarterectomy is an established surgical procedure to prevent stroke. The indications, preoperative evaluation, surgical timing, technical details, complications, and special circumstances for the use of this operation are reviewed. Future developments in the surgical reconstruction of the extracranial caroti...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1040902
更新日期:1998-01-01 00:00:00
abstract::Evaluation of patients with cranial neuropathies requires an understanding of brainstem anatomy and nerve pathways. Advances in neuroimaging, particularly high spatial resolution magnetic resonance imaging (MRI), have enabled visualization of these tiny structures and their related pathology. This review provides an a...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1331807
更新日期:2012-09-01 00:00:00
abstract::Clinical guidelines for the determination of brain death in children were first published in 1987. These guidelines were revised in 2011 under the auspices of the Society of Critical Care Medicine, the American Academy of Pediatrics, and the Child Neurology Society, and provide the minimum standards that must be satis...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1547540
更新日期:2015-04-01 00:00:00
abstract::Autoimmune encephalopathy represents a complex category of disease with diverse immunologic associations, clinical manifestations, and therapeutic outcomes. Three main subgroups include autoimmune encephalopathies without cancer but with neural nonspecific serologic evidence of autoimmunity (encompassing "Hashimoto's ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1277985
更新日期:2011-04-01 00:00:00
abstract::With the growth of wheelchair athletics at both grassroots and national levels, there has been an increased incidence of sports-related and overuse syndromes in the wheelchair-user population. This article provides an overview of the available literature on the incidence, prevalence, evaluation, prevention, and rehabi...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2000-9829
更新日期:2000-01-01 00:00:00
abstract::The use of technology in neurology education has revolutionized many aspects of medical teaching, addressing some important challenges of modern education such as information overload and the unique needs of millennial learners. However, it also has inherent problems, such as depersonalization and high development cos...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1666985
更新日期:2018-08-01 00:00:00
abstract::Osteoporosis is a debilitating disease that occurs in epidemic proportions in Western societies and has a large economic impact. Percutaneous vertebroplasty is successful in alleviating subacute and chronic pain caused by osteoporotic compression fractures and pathological vertebral fractures from tumor infiltration. ...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2002-36538
更新日期:2002-06-01 00:00:00
abstract::The accumulation of fibrillar α-synuclein protein is the pathological hallmark occurring in both multiple system atrophy (MSA) and diffuse Lewy body disease (DLBD). The oligodendrocytes are especially involved in MSA, while subtypes of neurons are the targets in DLBD. In both instances, the changes are widespread with...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1381732
更新日期:2014-04-01 00:00:00
abstract::Listeria monocytogenes infection of the central nervous system is often not recognized and treated appropriately in the crucial early stages of the disease. Most consider patients with underlying disease or immunocompromised states to be at risk, although healthy individuals may present with a neurologic syndrome caus...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2000-9398
更新日期:2000-01-01 00:00:00
abstract::Dopamine agonists provide an effective means of treating early, middle, and late stages of Parkinson's disease. This article outlines the advantages and disadvantages of dopamine agonists as compared with levodopa therapy. The features and costs of the four Food and Drug Administration-approved agonists (bromocriptine...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2001-13114
更新日期:2001-01-01 00:00:00
abstract::The clinical history and neurological examination provide the most important data on which the diagnosis of autoimmune myasthenia gravis (MG) is based. MG produces symptomatic weakness that predominates in certain muscle groups and typically fluctuates in response to effort and rest. The diagnosis of MG therefore depe...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2004-829594
更新日期:2004-03-01 00:00:00
abstract::Alteration in neural control from suprapontine areas to the nerves innervating the bladder can lead to bladder dysfunction and the development of a neurogenic bladder (NGB). Patients with NGB often suffer from urinary incontinence, which can lead to adverse events such as urinary tract infections and decubiti, in addi...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1571216
更新日期:2016-02-01 00:00:00
abstract::Nontraumatic spontaneous intracranial hemorrhage occurs most commonly into the subarachnoid space and brain parenchyma, in contrast to subdural and epidural hematomas that are usually traumatic. The differential diagnosis of nontraumatic subarachnoid hemorrhage includes intracranial aneurysm rupture and vascular malfo...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1083691
更新日期:2008-09-01 00:00:00
abstract::Intracerebral hemorrhage (ICH), which constitutes 10 to 15% of all strokes and affects approximately 65,000 people each year in the United States, has the highest mortality rate of all stroke subtypes. Hypertension, cerebral amyloid angiopathy, and anticoagulation underlie the majority of cases of ICH. Warfarin not on...
journal_title:Seminars in neurology
pub_type: 杂志文章,评审
doi:10.1055/s-2005-923538
更新日期:2005-12-01 00:00:00