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Non-traumatic neurological conditions in medico-legal work
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
The pathologist may be asked to examine cases where an individual has died as a result of medical intervention in which the most significant pathology will be in the nervous system. This section considers neuropathology that can develop as a result of the invasive intervention and medical intervention.
Cognitive function, ageing, and dementia
Published in Philip N. Murphy, The Routledge International Handbook of Psychobiology, 2018
Eef Hogervorst, Nils Niederstrasser
Risk factors are thought to influence the progression rate of the underlying neuropathology and may impact timing of the clinical onset of dementia. Non-modifiable risk factors include age, gender and genetic profile. For instance, global incidence rates for dementia are known to increase with age (World Health Organization, 2012). Additionally, prevalence of dementia is shown by some studies to be higher in females compared to males, and this difference is augmented with age (World Health Organization, 2012).
Birth
Published in Rudi Coetzer, The Notebook of a New Clinical Neuropsychologist, 2017
So where do we start when seeing a patient for the first time? The answer is very concrete: find the patient’s file. Sometimes easier said than done, especially in huge, busy, chaotic hospitals. Don’t automatically ask a nurse to find it for you, Dr Burger counsels me. They have their own work to do. Find the file yourself, learn the mechanics of your hospital’s patient administration system. You might need this skill one day. Usually late on a Friday afternoon, during a crisis! Anyway, never let anyone, least of all the nursing staff get even a whiff that you think mundane tasks such as locating a file is beneath you. Find the file. Read the clinical notes. Identify what is relevant. It is not always straightforward. Handwriting is often illegible, old faxes faded into oblivion. Medical terms used incomprehensible. Sometimes more than one volume of notes to trawl for information. Which section of the file would contain the relevant stuff? The truth is it depends on the type of neuropathology. It could be any section, or even any combination of sections. But emergency room attendance is a good place to start, especially for acute onset pathologies such as head trauma and cerebro-vascular accidents (strokes). For slowly evolving neuropathology read over the family medicine or internal medicine notes. Have a look at GP letters. Radiology is obviously a section never to be skipped. More generally, scattered throughout the file, the medical record can also be a good place to learn a little bit more about the social history of a patient.
Neuropathological images in the great pathology atlases
Published in Journal of the History of the Neurosciences, 2022
Peter J. Koehler, Douglas J. Lanska
Neuropathology, as part of pathology, has been described in numerous books since Galen (129–200/216 CE).1Norman mentions the following authors of works on neuropathology to the middle of the nineteenth century: Galenus, Benivienti, Fernel, Schenck, Severino, Bonet, Friederich Hoffmann, Morgagni, John Hunter, Eduard Sandifort, Johann Gotlieb Walter, Baillie, J. H. Meckel, Bright, Cruveilhier, William Edmonds Horner, Lobstein, Hope, Hodgkin, Carswell, Samuel David Gross, Rokitansky, and Addison (Norman 1991). The localization of pathology in circumscribed parts of the body, in contrast to the humoral pathophysiological theories, however, gradually started in the eighteenth century. At that time it was also referred as “morbid anatomy” (Maulitz 1997). During the second half of that century, we observe a gradual evolution from unillustrated works with an irregular and uneven collection of pathologic material to treatises with comprehensive and beautiful illustrations. This involved fundamental changes in approach to collection of pathological material, methods of graphic illustration, and also techniques of printing.
Contemporary challenges in the diagnosis and management of chronic inflammatory demyelinating polyneuropathy
Published in Expert Review of Neurotherapeutics, 2022
Although considered mandatory for a definitive diagnosis of CIDP by older criteria [53], nerve pathology has since been convincingly shown to be of little value in most patients with suspected CIDP [54]. This is because pathological findings are diverse, poorly sensitive, and mostly nonspecific. Furthermore, results are highly dependent on the availability of adequate neuropathological laboratory facilities and the expertise of neuropathologists with experience in peripheral nerve disease [55]. For those reasons, nerve biopsy is only justified in cases of suspected CIDP with no response to treatment and when alternative, especially treatable disorders are possible. However, even in these cases, specified within the updated guidelines, it is highly debatable as to whether neuropathology adds real benefit, particularly as other noninvasive and reliable diagnostic methods are available when alternative diagnoses are under consideration. Furthermore, the potential complications of nerve biopsy, although rare, should be taken into account. As such, for diagnosis of CIDP itself, it appears only exceptionally justified to perform a nerve biopsy, with few studies suggesting it may be more frequently useful, importantly coming from highly specialized units [56].
Alexithymia is a non motor symptom of essential tremor regardless of the presence of depression and anxiety
Published in Neurological Research, 2020
Yildizhan Sengul, Hakan Serdar Sengul, Elif Gokcal, Ismet Ustun, Ahmet Ozturk, Onur Yilmaz, Gulsen B. Yildiz, Elan D. Louis
Knowledge regarding the neuroanatomical connections that cause cognitive and affective disorders in the context of cerebellar damage has increased due to recent research regarding CCAS [30]. This research offers us a context in which to interpret psychiatric symptoms in ET, a disease of cerebellar pathology. These studies have found that the cerebellum participates in limbic-related functions (including emotion and affect). The fastigial nucleus has projections to the ventral tegmental area and the septum, hippocampus, and amygdala connect to the cerebellum via cerebellar interconnections. Other studies indicate that paralimbic and prefrontal cortices connect the cerebellar cortex and cerebellar nuclei [31]; the cerebellum has been implicated in bipolar disorder, schizophrenia, depression, and anxiety disorders [32]. ET also manifests a wide range of neuropsychiatric symptoms; affective disorders, such as anxiety and depression, as well as personality changes, have been especially studied [33]. The recognition and treatment of non-motor symptoms will not only contribute to a better understanding of the neuropathology of the disease but will also contribute to increased quality of life for patients and improved motor and non-motor function as has been observed in PD [34].