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The Neurologist in Film
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
Medicine is specialized, and expertise is divided over multiple areas. Physicians have a good idea of what these fields of medicine entail. For everyone else, the question is: what is a neurologist? The American Academy of Neurology (AAN) defines a neurologist as “a medical doctor with specialized training in diagnosing, treating, and managing disorders of the brain and nervous system.” According to the AAN website, the disorders that neurologists treat are Alzheimer’s disease and other dementias, brain injury and concussion, stroke, brain tumors, epilepsy, migraine and other headaches, multiple sclerosis, myasthenia gravis, peripheral neuropathy, chronic and acute such as Guillain-Barré syndrome, amyotrophic lateral sclerosis, Parkinson’s disease and other movement disorders, sleep disorders, and spinal cord injury. Many neurologists have been trained in a subspecialty, and acute neurologic disorders are often seen by neurointensivists, neurohospitalists, vascular neurologists, and epileptologists.
Nutritional Deficiencies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Deepa Bhupali, Fernando D. Testai
Neurologic symptoms: Paresthesia and numbness in the feet and later the fingers.Lhermitte's symptom occasionally.Impaired memory.Anosmia.Reduced visual acuity.Diminished taste.Impaired manual dexterity.Lower limb weakness (corticospinal tract lesions and peripheral neuropathy).Unsteady gait.Impotence.
Fibromyalgia
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Fibromyalgia is a complex chronic health condition that causes widespread pain and tenderness and a heightened sensitivity to sounds, light, and touch. The pain varies in intensity, migrates around the body, and has been described as stabbing and shooting, with deep muscular aching, throbbing, and twitching.1 Patients can also experience neurologic pain symptoms such as numbness and tingling or a burning sensation. Other symptoms often present include severe fatigue, sleep problems (waking up unrefreshed), and problems with memory or thinking clearly.2 Patients will also often have comorbidities including depression or anxiety, migraine or tension headaches, restless legs, skin sensitivity, impaired coordination, digestive problems including irritable bowel syndrome or gastroesophageal reflux disease (GERD), irritable or overactive bladder, pelvic pain, and temporomandibular disorder (TMJ).2 Fibromyalgia affects 2–4% of people, women much more often than men.
Caring for Relatives with Dementia in Times of COVID-19: Impact on Caregivers and Care-recipients
Published in Clinical Gerontologist, 2022
Andrés Losada, Carlos Vara-García, Rosa Romero-Moreno, Samara Barrera-Caballero, María del Sequeros Pedroso-Chaparro, Lucía Jiménez-Gonzalo, José Fernandes-Pires, Isabel Cabrera, Laura Gallego-Alberto, Cristina Huertas-Domingo, Laura Mérida-Herrera, Javier Olazarán-Rodríguez, María Márquez-González
Participants in this study were 88 family caregivers of people diagnosed with dementia who volunteered to participate. Diagnoses were made by neurologists. They were recruited through the Neurology Service of the Hospital Universitario Gregorio Marañón (Madrid, Spain). Caregivers were informed about the study by the Neurologist during checkups, and agreed to be contacted by the research team. In order to participate in the study, individuals were required to meet the following inclusion criteria: (a) identify themselves as the principal person taking care of a relative diagnosed with dementia; (b) devote at least 1 hour per day to the care of the relative; and (c) have provided care for at least 3 months to that relative. Telephone interviews were conducted with all the caregivers during the period from June 2020 to the middle of March of 2021. The interviews were conducted by clinical psychologists with at least Master Degree in Clinical Psychology, which were specifically trained for this task. All caregivers signed an informed consent and the study was approved by the Ethics Committee of the Universidad Rey Juan Carlos.
Validity of the Wechsler Abbreviated Scale of Intelligence, Second Edition (WASI-II) as an Indicator of Neurological Disease/Injury: A Pilot Study
Published in Brain Injury, 2021
Joseph J. Ryan, David S. Kreiner, Gordon Teichner, Samuel T. Gontkovsky
From an archival sample of 173 adults referred for neuropsychological assessment, a group of 32 patients with documented brain injury or disease were identified. A second group of 27 individuals without evidence of neurological disease or injury but with psychiatric disorders or age-related cognitive complaints was also selected. To be included in the study, each participant was administered the WASI-II as part of a more extensive evaluation, had an official diagnosis based on established criteria from the DSM-5, ICD-10, or other appropriate source, and had completed at least nine years of formal education. All diagnoses were made by appropriate health care providers such as neurologists, neurosurgeons, psychiatrists, or neuropsychologists. In some cases the neuropsychologist and referring physician collaborated to arrive at a final diagnosis. It should be noted that all patients were referred for clinical reasons and were not involved in litigation related to their medical status at the time of their neuropsychological evaluations. In this light, symptom and performance validity tests were not routinely administered as part of the assessment battery. Of the total sample, approximately 5% of the evaluations included one of these measures and results in all cases revealed no concerns with respect to validity. Further, patients were provided with reasonable breaks in testing at appropriate times in order to minimize any potential effects of fatigue. Institutional review board approval was provided for this archival study from a medical center located in the Midwestern United States.
Diagnosis and conservative management of great toe pathologies: a review
Published in Postgraduate Medicine, 2021
Nicholas A. Andrews, Jessyca Ray, Aseel Dib, Whitt M. Harrelson, Ankit Khurana, Maninder Shah Singh, Ashish Shah
A brief neurological examination of the lower extremity should be completed in all patients and includes lower extremity reflexes, muscle strength, and various tests to evaluate large and small fiber status. Patients with peripheral neuropathy may demonstrate a high stepping gait along with reduced lower extremity reflexes and sensation. Urgent evaluation of spinal cord, brain stem, and brain lesions should be completed in patients with no prior history of upper motor neuron dysfunction who demonstrate upper motor neuron signs along with bowel or bladder involvement. Clinicians should be aware of the common neurologic presentations of polyneuropathy, lumbar radiculopathy or plexopathy, and mono-neuropathies that can be distinguished based on the spatial distributions of sensory disturbances, motor neuron signs, and altered reflexes. In the event that this brief neurologic exam demonstrates any abnormalities, the patient should be sent for more thorough neurologic evaluations. These neurologic tests may include radiographic imaging studies, nerve conduction studies, or even nerve biopsies.