Abstract:
:Conventional disease-modifying agents are only moderately effective, so breakthrough disease activity is commonly seen. The evidence from randomized clinical trials and real-world observational data supporting the use of the second-line agents natalizumab, mitoxantrone, and cyclophosphamide are reviewed. Potential future treatment options are also discussed. Management algorithms for breakthrough disease are outlined.
journal_name
Neurol Clinjournal_title
Neurologic clinicsauthors
Marriott JJ,O'Connor PWdoi
10.1016/j.ncl.2010.12.005subject
Has Abstractpub_date
2011-05-01 00:00:00pages
411-22issue
2eissn
0733-8619issn
1557-9875pii
S0733-8619(10)00158-1journal_volume
29pub_type
杂志文章,评审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 fourth edition of The Diagnostic and Statistical Manual of Mental Disorders defines delirium as "a reversible state of confusion with a reduced level of consciousness manifest as an inability to focus, sustain or shift attention." Pharmacologic agents are important contributors to delirium in hospitalized elderly ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2004.01.001
更新日期:2004-05-01 00:00:00
abstract::This article concentrates primarily on infections of viral origin, although numerous microorganisms can infect the fetal and newborn brain (see Tables 1 and 2). Intrauterine infections occur most often for HIV, CMV and rubella, whereas HSV is preferentially transmitted intrapartum. In the last decade, changes in the e...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-08-01 00:00:00
abstract::Postamputation phenomena, including painful and nonpainful phantom sensations occur following loss of limbs and other body parts. Peripheral and central nervous system mechanisms play a role in persistent phantom pain. Understanding the pathophysiology of this syndrome has improved in recent years. Comprehensive evalu...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70105-5
更新日期:1998-11-01 00:00:00
abstract::CTS is a clinically defined syndrome; however, there is value added by an evidence-based electrodiagnostic approach to (1) efficiently confirm the diagnosis (particularly before invasive interventions), (2) to identify neurogenic mimickers or superimposed processes that may influence the response to treatment, and (3)...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2011.12.001
更新日期:2012-05-01 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 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::The major clinical uses for opioids are to control pain, suppress cough, and to treat diarrhea. These drugs, however, have the potential for abuse. It is postulated that the significant mood-altering effects of opioids combined with their pharmacology, in which tolerance and physical and psychological dependence occur...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-08-01 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::Stroke involving the brainstem and cerebellum frequently presents acute vestibular syndrome. Although vascular vertigo is known to usually accompany other neurologic symptoms and signs, isolated vertigo from small infarcts involving the cerebellum or brainstem has been increasingly recognized. Bedside neuro-otologic e...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2015.04.006
更新日期:2015-08-01 00:00:00
abstract::Pseudotumor cerebri is a perplexing syndrome of increased intra-cranial pressure without a space-occupying lesion. The terminology for the disorder has changed over the years and the diagnostic criteria revised to reflect advances in diagnostic technology and insights into the disease process. The classification and n...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/S0733-8619(03)00096-3
更新日期:2004-02-01 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::Sleeping and dreaming always have been a fundamental part of human existence. Most early writing on these subjects was almost entirely speculation. During the twentieth century, however, scientific observation and experimentation abounded. This article emphasizes the evolution of the key concepts and research findings...
journal_title:Neurologic clinics
pub_type: 历史文章,杂志文章
doi:10.1016/j.ncl.2005.07.001
更新日期:2005-11-01 00:00:00
abstract::Nerve conduction studies and needle electromyography provide important and complementary information as part of an electrodiagnostic study. Potential technical problems that are encountered during the studies may interfere with accurate and reliable acquisition of information and interpretation of the data. Recognitio...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2011.12.008
更新日期:2012-05-01 00:00:00
abstract::The autosomal dominant spinocerebellar ataxias are a diverse and clinically heterogeneous group of disorders characterized by degeneration and dysfunction of the cerebellum and its associated pathways. Clinical and diagnostic evaluation can be challenging because of phenotypic overlap among causes, and a stratified an...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2013.04.006
更新日期:2013-11-01 00:00:00
abstract::The nature, prevalence, and course of cognitive and emotional disturbances in multiple sclerosis (MS) are described in this article. Mild to moderate cognitive impairment is common in MS and may be more incapacitating than physical symptoms for some patients. Although existing neurologic and neuroimaging procedures ca...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-02-01 00:00:00
abstract::Paraproteinemia frequently is associated with peripheral neuropathy. The clinical manifestations can be protean owing to the potential for multiple organ involvement. A methodical diagnostic approach to patients who have a plasma cell dyscrasia and neuropathy is necessary to ensure the appropriate detection of more wi...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2006.12.002
更新日期:2007-02-01 00:00:00
abstract::Cervicogenic headache is pain referred to the head from a source in the cervical spine or mediated by cervical nerves. Clinical features allow for no more than a diagnosis of probable cervicogenic headache. Definitive diagnosis requires evidence of a cervical source of pain. For most treatments, the evidence is limite...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2013.11.005
更新日期:2014-05-01 00:00:00
abstract::Face recognition is one of the most complex visual tasks performed by the human brain. Data from monkeys suggest that area IT may play a key role in identifying faces, and functional imaging research suggests that the human homologue of IT may be located in the medial occipitotemporal cortex, where a FFA has been loca...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(02)00106-8
更新日期:2003-05-01 00:00:00
abstract::There are a number of medications that effectively relieve symptoms in patients with functionally disabling tics. Neuroleptic drugs remain the most predictably effective tic-suppressing agents, but other approaches may be beneficial. This article reviews the spectrum of available therapies to suppress tics and provide...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70321-2
更新日期:1997-05-01 00:00:00
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::Oromandibular disorders are functional disorders and associated pains in the anatomic region of the temporomandibular joint. Their diagnosis and treatment are controversial because of the lack of conformity concerning these disorders among health care providers. This article provides a clear classification of these di...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1990-11-01 00:00:00
abstract::Epilepsy surgery is assuming greater importance in treating patients with partial epilepsy whose seizures are uncontrolled with antiepileptic drugs. Many good candidates for surgical treatment are not presented with the option of surgery. The evaluation for epilepsy surgery is extensive and includes several stages of ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
abstract::Drug-induced seizures are a commonly encountered problem for physicians. In this article, drugs that cause seizures are discussed with regards to the incidence of seizures, associated clinical factors, risk factors, and special treatment considerations. This information should help physicians determine appropriate eva...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
abstract::A number of changes have occurred in the management of Parkinson's disease in recent years, with the development of new therapeutic strategies based upon advances in pharmacotherapy and interventional procedures. The treatment of patients with Parkinson's disease is considered here with these advances in mind. Potenti...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70008-6
更新日期:2001-02-01 00:00:00
abstract::The authors review iatrogenic complications of stereotactic surgery, including tumor biopsy, cyst or abscess aspiration, movement disorder surgery, and radiosurgery. The expected morbidities and steps taken to reduce complications are also discussed. ...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/s0733-8619(05)70366-2
更新日期:1998-02-01 00:00:00
abstract::Giant cell arteritis is a systemic vasculitis with a wide clinical spectrum, and it represents a medical emergency. Visual loss is the most feared complication, and when it happens, it tends to be profound and permanent. Prompt diagnosis and treatment are imperative to minimize potentially devastating visual loss and ...
journal_title:Neurologic clinics
pub_type: 杂志文章
doi:10.1016/j.ncl.2010.03.002
更新日期:2010-08-01 00:00:00
abstract::Viruses are a frequent cause of encephalitis. Common or important viruses causing encephalitis include herpesviruses, arboviruses, enteroviruses, parechoviruses, mumps, measles, rabies, Ebola, lymphocytic choriomeningitis virus, and henipaviruses. Other viruses may cause an encephalopathy. Host factors and clinical fe...
journal_title:Neurologic clinics
pub_type: 杂志文章,评审
doi:10.1016/j.ncl.2018.07.001
更新日期:2018-11-01 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::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