Abstract：
:Insomnia in its chronic form is present in high numbers of patients presenting to physicians. As older women who have medical problems have the highest rates of chronic insomnia, physicians must have a high index of suspicion and be prepared to explore various etiologic factors that might be operative. Treatment should focus on setting specific goals, with patients using strategies that combine lifestyle changes, behavioral interventions, and appropriate medications. OTC agents, sedating antidepressants at low dosages (trazodone, doxepin, amitriptyline, and others), and nonhypnotic benzodiazepines are insufficiently studied to provide evidence-based support for their use to treat chronic insomnia. Particularly in the elderly, close monitoring is needed to prevent falls, accidents, and cognitive impairment from these agents. FDA-labeled hypnotic agents are efficacious, but long-term studies have not been available until the recent release of eszopiclone in the United States. Recent work encourages the use of CBT even in patients who have used sleeping pills for several years, although the success of CBT has been less encouraging when applied to chronic insomnia sufferers who have concurrent psychiatric disorders and who have taken hypnotics for years.
journal_name
Neurol Clinjournal_title
Neurologic clinicsauthors
Becker PMdoi
10.1016/j.ncl.2005.05.002subject
Has Abstractpub_date
2005-11-01 00:00:00pages
1149-63issue
4eissn
0733-8619issn
1557-9875pii
S0733-8619(05)00037-Xjournal_volume
23pub_type
杂志文章,评审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：: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：:Reflex sympathetic dystrophy (RSD) and causalgia appear to reflect identical pictures even though the latter is related to nerve injury and the former is not. Overriding past and present skepticism about a role for the sympathetic system in their cause and treatment, the International Association for the Study of Pain...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1995-05-01 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：: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：: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：: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：: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：:"Myasthenia gravis (MG) is the most common autoimmune neuromuscular disorder. This article highlights several cases that the practicing neurologist may encounter in the treatment of MG. Diagnostic uncertainty continues to be an issue in patients who are seronegative to the 2 most common antibodies, acetylcholine recep...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2020.03.005
更新日期：2020-08-01 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：:Mortality and morbidity from kidney disease and the spectrum of renal-associated neurologic disease have changed markedly since the introduction of renal dialysis and with the advent of renal transplantation. This article includes historical studies of the neurologic complications of acute uremia, now fairly uncommon,...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8619(03)00052-5
更新日期：2002-02-01 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：: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：: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. Fol...
journal_title：Neurologic clinics
pub_type： 杂志文章
doi：10.1016/j.ncl.2006.02.002
更新日期：2006-05-01 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：: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：:The vasculitides are a heterogeneous group of disorders that cause blood vessel inflammation and necrosis. Vasculitis may represent a primary disease process or a secondary manifestation of an underlying systemic condition. Neurologic symptoms and signs are common in most of the vasculitic syndromes and may be the pre...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1989-08-01 00:00:00
abstract：:The reasonable clinical approach to the patient who has low back pain includes a search for any of the red flags that would prompt consideration of additional diagnostic testing for serious underlying disease. The common patterns of back pain would be explored in an effort to categorize the patient's symptoms and to b...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8619(05)70113-4
更新日期：1999-02-01 00:00:00
abstract：:Toxic myopathies may occur with a variety of prescribed medications, illicit drug abuse, or other toxins. The article discusses an overview of some of the compounds that may cause myopathy, the clinical and laboratory features, histology, mechanisms of action, and potential risk factors of myopathy. The ability to rec...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8619(05)70341-8
更新日期：1997-08-01 00:00:00
abstract：:Current law in the United States authorizes physicians to diagnose brain death by applying generally accepted neurologic criteria for determining loss of function of the entire brain. This article offers a medical-legal perspective on problems that may arise with respect to the determination of brain death. These incl...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8619(05)70132-8
更新日期：1999-05-01 00:00:00
abstract：:In vitro and in vivo studies of striatal dopamine receptor changes have been reviewed in this article. A background of receptor pharmacology methods has been included to assist the reader in assessing the merits of the published studies. Overall the literature is not consistent in the relevant observations in parkinso...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：
更新日期：1992-05-01 00:00:00
abstract：:Since its clinical introduction in the early 1980s, MRI has transformed the practice of differential diagnosis and disease monitoring for disorders affecting the central nervous system, in particular multiple sclerosis and the allied inflammatory demyelinating diseases. Widespread and dynamic inflammatory processes of...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2008.09.012
更新日期：2009-02-01 00:00:00
abstract：:Many substances, organic and manufactured, may induce peripheral nerve damage when exposed to them. The expected clinical phenotype is of a distal, sensory or sensorimotor polyneuropathy, often painful, with axonal characteristics on electrodiagnostic and histopathologic analysis. Treatment is limited; often, the only...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2004.12.003
更新日期：2005-05-01 00:00:00
abstract：:What the study of EAE has taught us that has relevance to human demyelinating diseases is discussed. ...
journal_title：Neurologic clinics
pub_type： 杂志文章
doi：
更新日期：1983-08-01 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：: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：:Oxidative phosphorylation (OXPHOS) accounts for approximately 95% of the adenosine triphosphate (ATP) produced by the cell. The central nervous system, peripheral nervous system, cardiac muscle, skeletal muscle, and smooth muscle are highly susceptible to dysfunction of this complex enzyme system. Although most OXPHOS...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8619(05)70180-8
更新日期：2000-02-01 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：:Primary angiitis of the central nervous system (PACNS) is a vasculitis of small arteries and veins of unknown cause restricted to the central nervous system (CNS), and controversy and disagreement exist over the means to establish the diagnosis. Cerebral arteriography, cerebrospinal fluid examination, and MRI singly o...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/j.ncl.2014.12.004
更新日期：2015-05-01 00:00:00
abstract：:Neurologic emergencies are common among cancer patients and their incidence is increasing as patients live longer as a result of improved antineoplastic therapy. This article reviews acute neurologic complications in cancer patients. Among those complications reviewed are brain metastases, epidural spinal cord compres...
journal_title：Neurologic clinics
pub_type： 杂志文章,评审
doi：10.1016/s0733-8619(05)70072-4
更新日期：1998-05-01 00:00:00
