Abstract：
:In this series of clinical vignettes, the authors have attempted to provide a "feel" for the varied causes of syncope. The neurologist should be able to diagnose most causes of syncope using a simple algorithmic approach. Initial evaluation includes detailed clinical history, physical examination, and 12-lead ECG. Following initial evaluation, the cause of syncope is usually immediately apparent (typical story for vasovagal syncope, clinically demonstrable autonomic failure, long QT), strongly suspected (syncope preceded by chest pain or palpitations), or uncertain. In the latter group of patients, further workup will depend on the suspicion or documented presence of heart disease. In those with a single episode of syncope and no evidence of heart disease, further workup may not be necessary. In patients over 60 years of age with recurrent episodes and no cardiac history or abnormal ECG, tilt-table testing and carotid sinus massage may be diagnostic. If no diagnosis is found, an implantable loop monitor may be needed. Patients with heart disease will need the most comprehensive evaluations, possibly including exercise testing, cardiac electrophysiology, and tilt-table testing. As better understanding of pathophysiology and epidemiology emerge, under-standing of the diagnosis and treatment of syncope will improve. In the meantime, there is no substitute for astute clinical acumen.
journal_name
Neurol Clinjournal_title
Neurologic clinicsauthors
Schondorf R,Shen WKdoi
10.1016/j.ncl.2006.02.002subject
Has Abstractpub_date
2006-05-01 00:00:00pages
215-31issue
2eissn
0733-8619issn
1557-9875pii
S0733-8619(06)00026-0journal_volume
24pub_type
杂志文章abstract：:The appropriate diagnosis of the patient with epilepsy is first dependent on a determination of the type of seizure. When the type of seizure has been determined, consideration must be given to the nature of the epileptic syndrome, including concerns regarding the etiology of the attacks. The gradual evolution of the ...
journal_title：Neurologic clinics
pub_type： 杂志文章
doi：
更新日期：1986-08-01 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：: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：: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：:Overall, the majority of patients with optic pathway tumors will have stable disease regardless if they are radiated or receive chemotherapy. This is a very indolent tumor system and, for the most part, not a threat to life. Because of this, issues regarding appropriate therapeutic approaches have yet to be resolved. ...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1991-05-01 00:00:00
abstract：:Neurologists frequently evaluate patients complaining of vision loss, especially when the patient has been examined by an ophthalmologist who has found no ocular disease. A significant proportion of patients presenting to the neurologist with visual complaints have nonorganic or functional visual loss. Although there ...
journal_title：Neurologic clinics
pub_type： 杂志文章
doi：10.1016/j.ncl.2010.03.012
更新日期：2010-08-01 00:00:00
abstract：:"Deep brain stimulation is a safe and effective therapy for the management of a variety of neurologic conditions with Food and Drug Administration or humanitarian exception approval for Parkinson disease, dystonia, tremor, and obsessive-compulsive disorder. Advances in neurophysiology, neuroimaging, and technology hav...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2020.09.004
更新日期：2021-02-01 00:00:00
abstract：:Neoplastic meningitis appears to be increasing in frequency with improvements in the treatment of many cancers. It is most often recognized in patients with leukemia, breast cancer, lymphomas, and small-cell cancer of the lung, although it may be seen with virtually any malignancy. Treatment should include intrathecal...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1991-11-01 00:00:00
abstract：:Recognizing and treating the cause of pain in the patient with cancer should be the initial approach to the management of this common symptom. Careful analysis of patients with cancer and pain has led to the elucidation of common neurologic pain syndromes unique to this disease process. Pain in patients with cancer is...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1989-05-01 00:00:00
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：: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：:Neurologic complications are a major cause of morbidity, complicating open heart surgery, cardiac catheterization, and interventional techniques. Global or focal brain ischemia related to embolism or hypoperfusion predominates. Breakthrough cerebral hemorrhage and infection can complicate cardiac transplantation. Iden...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1992-02-01 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：:The needle electromyographic (EMG) examination is a challenging component of the electrophysiologic study. Knowledge of anatomy and physiology, sound EMG technique, and good patient rapport are required. Every muscle sampled by needle EMG is assessed for insertional activity, spontaneous activity, and voluntary motor-...
journal_title：Neurologic clinics
pub_type： 杂志文章
doi：10.1016/s0733-8619(01)00005-6
更新日期：2002-05-01 00:00:00
abstract：:This article reviews the evidence for comorbidity of migraine with psychiatric disorders, particularly the affective and anxiety disorders. Studies of the association between migraine and depression in both clinical and community studies have provided consistent evidence regarding a substantial degree of comorbidity b...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8619(05)70298-x
更新日期：1997-02-01 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：: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：: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：:Channelopathies, neuromuscular junction disorders, and myopathies represent multiple mechanisms by which toxins can affect the peripheral nervous system. These toxins include ciguatoxin, tetrodotoxin, botulinum toxin, metabolic poisons, venomous snake bites, and several medications. These toxins are important to be aw...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2020.07.001
更新日期：2020-11-01 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
abstract：:Severe acquired brain injury has profound impact on alertness, cognition, and behavior. Among those who survive the initial injury, a significant minority fail to fully recover self and environmental awareness, and go on to experience prolonged disorders of consciousness (DOC) that can last a lifetime. Although there ...
journal_title：Neurologic clinics
pub_type： 历史文章,杂志文章,评审
doi：10.1016/j.ncl.2011.07.009
更新日期：2011-11-01 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：:Impairments of visual perception resulting from brain damage can have serious implications for many aspects of patients' lives, and these impairments should be targeted for intervention. Rehabilitation programs need to be individually tailored to each patient's needs; thus, characterization of a patient's visual perce...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8619(02)00105-6
更新日期：2003-08-01 00:00:00
abstract：:In the current era of escalating globalization with rapid transport, changing climate, and an ever growing human population with associated changes in lifestyle, poverty, and war, the emergence of new neurologic infections is accelerated. Understanding their origins using epidemiologic and molecular tools will contrib...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2008.04.003
更新日期：2008-08-01 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：:Electronystagmography in 1990 should identify a vestibular abnormality with which to associate the clinical symptoms. The vestibular test battery method and interpretation reveals its application in neurotologic diagnosis. ...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1990-05-01 00:00:00
abstract：:This article defines the evolving role of the neurologist as a provider of palliative care. As neurologists care for chronically and critically ill, dying patients, and individuals whose diseases are incurable at the time of diagnosis, clinical competence requires expertise in the principles and practice of palliative...
journal_title：Neurologic clinics
pub_type： 杂志文章
doi：10.1016/s0733-8619(05)70047-5
更新日期：2001-11-01 00:00:00
abstract：:This review explores the principle features of the immunopathology of multiple sclerosis (MS), particularly relapsing-remitting MS. It highlights the emerging concepts in the pathogenesis of MS in the context of known features of pathology, including the characterization of cytokine networks promoting inflammatory dam...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2010.12.009
更新日期：2011-05-01 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：: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
