Enzyme inducers-- pearls
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); enzyme inducers adverse effects (partial) include1. decrease efficacy of oral contraception2. osteomalacia3. halve dose of many drugs, rendering them ineffective; this includes chemotherapeutic agents for children having CLL who have greater mortality on these drugs4. increase cholesterol5. Decrease testicular sizevar pageTracker = _gat._getTracker("UA-3639768-12"); pageTracker....
Source: neurologyminutiae - August 21, 2015 Category: Neurology Source Type: blogs
Narrow and broad spectrum antiepileptic drugs
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); Narrow spectrumcarbamazepineoxcarbazepinetiagabinegabapentinpregabalinBroad spectrumvalproic acidtopiramatelamotriginelevetiracetamzonisamideparampanelvar pageTracker = _gat._getTracker("UA-3639768-12"); pageTracker._initData(); pageTracker._trackPageview(); (Source: neurologyminutiae)
Source: neurologyminutiae - August 21, 2015 Category: Neurology Source Type: blogs
New Epilepsy classification
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); I GeneticII Focal a. Aware b UnawareIII MixedIV UnknownV Secondary generalizedvar pageTracker = _gat._getTracker("UA-3639768-12"); pageTracker._initData(); pageTracker._trackPageview(); (Source: neurologyminutiae)
Source: neurologyminutiae - August 21, 2015 Category: Neurology Source Type: blogs
IV valproate inferior for acute migraine
Friedman BW, Garber L, Yoon A, et al. Randomized trial of iv valproate vs.metoclopramide v. ketorolac for acute migraine. Neurology 2014; 82:976-983. Authors randomized 330 patients in ER to get 1000 mg, 10 mg, or 30 mg of respective drugs above over an iv drip over 15 minutes in a double blind trial. On the primary measure of pain relief, valproate lost big to the other two drugs. On secondary measures of needing a rescue medication, iv valproate also lost. Comment-- great to have this knowledge but the two winning drugs each had relatively low sustained headache rel...
Source: neurologyminutiae - April 18, 2015 Category: Neurology Source Type: blogs
GPDS and NCSE
Foreman BM, Chassen J, Abou Khaled K, et al. Generalized periodic discharges in the critically ill: a case control study of 200 patients. Neurology 2012; 79:1951-1960 and editorial Jette N, Mosely BD. Generalized periodic discharges : More light shed on the old GPEDs Neurology 2012; 79: 1940-1. Authors found GPD's in 4.5 % of 3000 patients undergoing cEEG. These 200 patients had brain injury (44%), acute systemic illness (38%), cardiac arrest (15%) and epilepsy (3%). 27 % of GPD's had NCSE v. 8 % of controls. However, GPD's were not associated...
Source: neurologyminutiae - April 1, 2015 Category: Neurology Source Type: blogs
code for tpa
If you physically administer tpa; code 37195 If you are present evaluating a acute stroke, bill as highest level code (if you meet all the 'bullet points'). Add a statment "patient is critical and unstable'; document time spent; if it is 30-74 min; add 99291 (Source: neurologyminutiae)
Source: neurologyminutiae - March 25, 2015 Category: Neurology Source Type: blogs
Idiopathic hypertrophic pachymeningitis
Dumont AS, Clark AWm Sevick RJ, Myles ST. Idiopathic hypertrophic pachymeningitis: A report of two cases and review of the literature. Background-- Authors note entity was described by Charcot and Joffroy, and that there are three forms: spinal, intracranial and craniospinal (latter is rarer). Past cases were often attributed to specific etiologies but most recent cases are idiopathic after investigation. Authors case 1 underwent 2 surgeries for biopsy/decompression , had persistent pain and numbness, but was non progressive for 15 years after one early...
Source: neurologyminutiae - March 25, 2015 Category: Neurology Source Type: blogs
Encephalitis serological evaluation
Hsve
Cmv
Hiv 1 and 2
Vzv
Ebv
Toxo
Lyme
Mycoplasma pn
Leptospirosis
Legionella
Brucellosis
Chlamydia
Syphilis
Aspergillosis (Source: neurologyminutiae)
Source: neurologyminutiae - February 1, 2015 Category: Neurologists Source Type: blogs
Definite central fourth nerve palsy
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); per Neil MillerAn ipsilateral or contralateral relative afferent pupillary defect (RAPD) unassociated with any decrease in visual acuity, reduced color vision, or visual defect, but with setting of an isolated fourth nerve palsy, RAPD indicated localization to brachium of superior colliculus and almost always indicates the fourth nerve paresis is central in origin.var pageTracker = _gat._getTracker("UA-36397...
Source: neurologyminutiae - November 4, 2014 Category: Neurologists Source Type: blogs
Smartvest SQL
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); Chest wall oscillation approved for neuromuscular disease, 80 % paid by Medicare with assistance for rest.originally for bronchiectasisuse for thirty minutes twice dailywww.smartvest.comwww.ICD9data.com var pageTracker = _gat._getTracker("UA-3639768-12"); pageTracker._initData(); pageTracker._trackPageview(); (Source: neurologyminutiae)
Source: neurologyminutiae - October 17, 2014 Category: Neurologists Source Type: blogs
Galaxy portfolio for aed's-- low priced drugs
< div dir= " ltr " style= " text-align: left; " trbidi= " on " > < script type= " text/javascript " > var gaJsHost = (( " https: " == document.location.protocol) ? " https://ssl. " : " http://www. " ); document.write(unescape( " %3Cscript src= ' " + gaJsHost + " google-analytics.com/ga.js ' type= ' text/javascript ' %3E%3C/script%3E " )); < /script > UPSHER SMITH PORTFOLIO INCLUDES < br / > TOPIRAMATE ER (QUDEXY) 25,50,100, 150 , 200 MG TABS (NOT DISCOUNTED) < br / > < br / > Discounted: < br / > topiramate tablets < br / > divalproex delayed release tbalets < br / > valproic acid capsules, USP < br / > lamotrigine t...
Source: neurologyminutiae - October 17, 2014 Category: Neurology Source Type: blogs
Galaxy portfolio for aed's-- low priced drugs
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); UPSHER SMITH PORTFOLIO INCLUDES TOPIRAMATE ER (QUDEXY) 25,50,100, 150 , 200 MG TABS (NOT DISCOUNTED)Discounted:topiramate tabletsdivalproex delayed release tbaletsvalproic acid capsules, USPlamotrigine tabletscarbamazepine tabletsphenytoin extended release. advantagesreceive a consistent productuse a specialty pharmacy formMOBE referral kit available free with Rx.Use Thrifty White Pharmacy # 61eRx ...
Source: neurologyminutiae - October 17, 2014 Category: Neurologists Source Type: blogs
Charging for items outside the traditional billing codes.
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); based on summary article by Orly Avitzur, Neurology Today based ona presentation by health care lawyer Daniel Brown.New CPT codes for telephone/internet assessment when provided doctor to doctor by a consultant-- codes 99446-99449. May be used for complex and urgent situations when face to face is not practical. These are time based only codes and only available to consulting specialist. ME...
Source: neurologyminutiae - October 17, 2014 Category: Neurologists Source Type: blogs
Concise of brain antigens commonly tested
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); 1. NMDAR NR1 anti NMDAR encephalitis2. amphiphysin-- stiff person syndrome, encephalomyelitis,limbic encephalomyelitis, sensorimotor neuropathy3. ARHGAP 25, GRAF -- subacute inflammatory cerebellar ataxia4. CASPR2 (contactin associated protein 2)- Morvan syndrome, neuromyotonia, limbic encephalitis5. MOG -- ADEM, MS, CIS, NMO-SD6. GAD 65-- stiff person syndrome...
Source: neurologyminutiae - October 17, 2014 Category: Neurologists Source Type: blogs
Hydroxyurea and HbF in sickle cell disease
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www."); document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E")); Steinberg MH et al. Effect of hydroxyurea on mortality and morbidity in adult sickle cell anemia. Risks and benefits up to 9 years of treatment. JAMA 1003; 289: 1645-51. Weiner DL, et al. editorial: hydroxyurea and sickle cell disease. A chance for every patient.HbF is inversely related to mortality in SCD, and can be increased with hydroxyurea. Also cite Multicenter Study of hy...
Source: neurologyminutiae - October 9, 2014 Category: Neurologists Source Type: blogs
