Issue Overview
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: ISSUE OVERVIEW Source Type: research

Key Points for Issue
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: KEY POINTS FOR ISSUE Source Type: research

List of Abbreviations
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: LIST OF ABBREVIATIONS Source Type: research

Learning Objectives
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: LEARNING OBJECTIVES AND CORE COMPETENCIES Source Type: research

Errata
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: Errata Source Type: research

Postreading Self-Assessment and CME Test—Preferred Responses
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: SELF-ASSESSMENT AND CME Source Type: research

Postreading Self-Assessment and CME Test
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: SELF-ASSESSMENT AND CME Source Type: research

Instructions for Completing CME and Tally Sheet
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: SELF-ASSESSMENT AND CME Source Type: research

Coding in the World of COVID-19: Non–Face-to-Face Evaluation and Management Care
Almost all medical care in the United States is delivered with the provider and patient in immediate proximity; this model is referred to as face-to-face care. Medical services can be apportioned as procedural care (eg, surgery, radiology, or laboratory testing and others) or cognitive care, also known as Evaluation and Management (E/M) services, in which the provider formulates an assessment and plan after obtaining information from the patient’s history, examination, and diagnostic tests. (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: PRACTICE ISSUES Source Type: research

Drugs of Abuse and the Nervous System
This article discusses the neurologic complications of traditional, nontraditional, and emerging drugs of abuse. RECENT FINDINGS The manufacture, distribution, and use of so-called designer drugs are increasing. These agents can induce dramatic neurologic manifestations and can evade identification on conventional drug-screening assays. Additionally, gabapentinoids, drug agents that are very familiar to neurologists, are being abused in the general population at increasing rates to achieve euphoric highs and potentiate the effects of opiates. Furthermore, even well-known illicit narcotics such as heroin are posing dange...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Anticancer Drugs and the Nervous System
This article reviews the clinical features, prognosis, and treatment of neurotoxicity from anticancer drugs, including conventional cytotoxic chemotherapy, biologics, and targeted therapies, with a focus on the newer immunotherapies (immune checkpoint inhibitors and chimeric antigen receptor T cells). RECENT FINDINGS Whereas neurologic complications from traditional chemotherapy are widely recognized, newer cancer therapies, in particular immunotherapies, have unique and distinct patterns of neurologic adverse effects. Anticancer drugs may cause central or peripheral nervous system complications. Neurologic complication...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Commonly Used Drugs for Medical Illness and the Nervous System
This article provides an overview of the neurologic side effects of commonly prescribed medications, some of which can result in significant impairment if not addressed. This article aims to help clinicians recognize neurologic adverse drug reactions of a range of medication classes. RECENT FINDINGS Adverse drug reactions are a source of significant morbidity and rising health care costs. Failure to recognize neurologic adverse drug reactions may prompt unnecessary testing to identify a primary neurologic condition and expose the patient to continued adverse effects of a medication. Familiarity with the side effect prof...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Sarcoidosis and the Nervous System
This article provides an overview and update on the neurologic manifestations of sarcoidosis. RECENT FINDINGS The 2018 Neurosarcoidosis Consortium diagnostic criteria emphasize that biopsy is key for diagnosis and determines the level of diagnostic certainty. Thus, definite neurosarcoidosis requires nervous system biopsy and probable neurosarcoidosis requires biopsy from extraneural tissue. Without biopsy, possible neurosarcoidosis can be diagnosed if the clinical, imaging, and laboratory picture is compatible and other causes are ruled out. Recent large retrospective studies from the United States and France establishe...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Critical Medical Illness and the Nervous System
This article describes the neurologic complications that are commonly encountered in patients who are critically ill from medical diseases and presents strategies for their diagnosis, prevention, and treatment. RECENT FINDINGS Chronic neurologic disability is common after critical medical illness and is a major factor in the quality of life for survivors of critical illness. Studies that carefully assessed groups of patients with general critical illness have identified a substantial rate of covert seizures, brain infarcts, muscle wasting, peripheral nerve injuries, and other neurologic sequelae that are strong predicto...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Blood Cell Disorders and the Nervous System
This article discusses the epidemiology, diagnosis, treatment, and prevention of neurologic complications of common and rare blood cell disorders. recent findings A growing number of preventive treatment options are available for stroke in sickle cell disease. Paroxysmal nocturnal hemoglobinuria and immune thrombocytopenia can lead to stroke. Thrombotic thrombocytopenic purpura frequently causes neurologic symptoms and should be considered in the differential diagnosis of a patient with neurologic symptoms, thrombocytopenia, and hemolytic anemia. Polycythemia vera and essential thrombocythemia are rare causes of stroke....
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Electrolyte Disorders and the Nervous System
This article provides an overview of the major electrolyte disorders and discusses in detail the homeostasis, etiologies, neurologic manifestations, and treatment of these disorders. RECENT FINDINGS The diagnosis and management of hyponatremia continue to evolve. Diagnostic accuracy is improved by assessing serum and urine osmolality as well as urinary sodium. Avoiding overcorrection of hyponatremia is crucial to avoid osmotic demyelination syndrome, although even careful correction can cause osmotic demyelination syndrome in patients who have other risk factors. The clinical presentation of osmotic demyelination syndro...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Obstetric and Gynecologic Disorders and the Nervous System
This article highlights the multiple intersections between obstetric/gynecologic issues and neurologic disorders. RECENT FINDINGS Neurologic issues can arise related to contraceptive medications, infertility treatments, pregnancy, and menopause. This article explores these areas in chronologic order, beginning with women’s neurologic conditions that overlap their reproductive years and those that may occur during pregnancy and continuing through menopause. For each disorder, the epidemiology, pathophysiology, complications, and best sex-based treatment are described. Recent findings and treatments are highlighted....
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Rheumatologic Disorders and the Nervous System
This article describes the neurologic manifestations of systemic autoimmune diseases. RECENT FINDINGS Systemic autoimmune diseases can be associated with a wide spectrum of neurologic comorbidities involving the central and peripheral nervous systems. Systemic lupus erythematosus (SLE) can be associated with a number of manifestations predominantly affecting the central nervous system (CNS), whereas peripheral neuropathy is less common. Sjögren syndrome can be associated with peripheral neuropathy in 10% of cases and CNS disease in 2% to 5% of cases. The risk of stroke is increased in SLE, rheumatoid arthritis, tem...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Gastrointestinal Disorders and the Nervous System
This article describes the neurologic sequelae of various nutritional micronutrient deficiencies, celiac disease, inflammatory bowel disease, and liver disease. Where relevant, appropriate treatments for these conditions are also discussed. The developing field of the microbiome and nervous system interaction is also outlined. RECENT FINDINGS Pathology in the gastrointestinal system can affect the nervous system when it causes micronutrient deficiency, when immune responses created by the gastrointestinal system affect the nervous system, when toxins caused by gastrointestinal organ failure harm the nervous system, and ...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Cardiac and Pulmonary Disorders and the Nervous System
This article reviews the neurologic complications encountered with cardiac and pulmonary disorders, specifically focusing on endocarditis, cardiac arrest, heart failure, hypercapnia, hypoxia, and cystic fibrosis. As neurologic dysfunction is one of the most frequent complications of these diseases and may even be the presenting symptom, it is important to be familiar with these complications to foster early recognition and intervention. RECENT FINDINGS Advances have been made in the identification of which patients can safely undergo valvular surgery for treatment of infective endocarditis in the setting of stroke, whic...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

A Systematic Approach to Systemic and Multisystem Disease and the Nervous System
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: EDITOR’S PREFACE Source Type: research

Contributors
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: CONTRIBUTORS Source Type: research

Table of Contents
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: Table of Contents Source Type: research

Issue Overview
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: ISSUE OVERVIEW Source Type: research

Key Points for Issue
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: KEY POINTS FOR ISSUE Source Type: research

List of Abbreviations
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: LIST OF ABBREVIATIONS Source Type: research

Learning Objectives
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: LEARNING OBJECTIVES AND CORE COMPETENCIES Source Type: research

Postreading Self-Assessment and CME Test—Preferred Responses
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: SELF-ASSESSMENT AND CME Source Type: research

Postreading Self-Assessment and CME Test
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: SELF-ASSESSMENT AND CME Source Type: research

Instructions for Completing CME and Tally Sheet
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: SELF-ASSESSMENT AND CME Source Type: research

Innovations in Prehospital Stroke Management Utilizing Mobile Stroke Units
Using a representative case, this article discusses prehospital innovations for patients with acute large vessel occlusion ischemic stroke, including mobile stroke unit care supported by advanced field imaging. (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: PRACTICE ISSUES Source Type: research

Legal Liability Associated With rtPA Administration and Surrogate Decision Makers
This article examines the issues of surrogate decision makers and the physician’s potential legal liability in the context of the administration or nonadministration of recombinant tissue plasminogen activator (rtPA) in a common emergency department scenario. (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: MEDICOLEGAL ISSUES Source Type: research

Management of Unruptured Cerebral Aneurysms and Arteriovenous Malformations
This article provides a practical approach to the management of unruptured intracranial aneurysms and unruptured brain AVMs and reviews the risk of rupture, risk factors for rupture, preventive treatment options with their associated risks, and the approach of treatment versus observation for both types of vascular malformations. RECENT FINDINGS For unruptured intracranial aneurysms, scoring systems on the risk of rupture can help with choosing preventive treatment or observation with follow-up imaging. Although the literature provides detailed information on the complication risks of preventive treatment of unruptured ...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Surgical Approaches to Stroke Risk Reduction
This article examines the evidence for using the available options. RECENT FINDINGS Carotid endarterectomy is an effective treatment option for reducing the risk of stroke in appropriately selected patients. Patients should be stratified for future stroke risk based on both the degree of stenosis and the presence of symptoms referable to the culprit lesion. Carotid stenting is also useful in reducing stroke risk, again in carefully selected patients. Because of the publication of significant data regarding both carotid endarterectomy and carotid artery stenting in the last several years, selection can be far more person...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Medical Management for Secondary Stroke Prevention
This article reviews the evidence base and recommendations for medical management for secondary stroke prevention. RECENT FINDINGS Recent developments for secondary stroke prevention include evidence to support the use of short-term dual antiplatelet therapy after minor stroke and transient ischemic attack, direct oral anticoagulants for nonvalvular atrial fibrillation, reversal agents for direct oral anticoagulant–associated hemorrhage, and aspirin rather than presumptive anticoagulation with a direct oral anticoagulant for embolic stroke of undetermined source. SUMMARY Most strokes are preventable. The mainst...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Recovery After Stroke
This article describes restorative therapies to improve patient outcomes after stroke. These therapies contrast with acute stroke treatments such as recombinant tissue plasminogen activator (rtPA) and thrombectomy that target clots, aim to salvage threatened brain tissue to limit injury, and have a time window measured in hours. Restorative therapies target the brain, aim to promote plasticity within surviving brain tissue, and have a time window measured in days to weeks or longer. RECENT FINDINGS A number of drugs are under study. Preclinical studies are providing attractive therapeutic candidates for translation, suc...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Ischemic Stroke in Young Adults
This article reviews current knowledge on epidemiology, risk factors and causes, diagnostic considerations, management, and prognosis of ischemic stroke in young adults (those 55 years old and younger). RECENT FINDINGS The incidence of ischemic stroke in young adults has been increasing since the 1980s, which has occurred in parallel with increasing prevalence of vascular risk factors and substance abuse among the younger population. Young adults have a considerably wider range of risk factors than older patients, including age-specific factors such as pregnancy/puerperium and oral contraceptive use. Behavioral risk fac...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Stroke in Women
This article reviews sex differences in stroke risk and presentation, with a particular emphasis on the unique risk factors women experience throughout the lifespan. RECENT FINDINGS Although prior studies suggested women have worse outcomes after stroke, it is now clear that age, prestroke functional status, and comorbidities explain many of the differences between men and women in stroke severity, functional outcomes, and mortality. Several meta-analyses and large cohort studies have evaluated the risk factors for women related to reproductive factors and found that fewer years between menarche and menopause, pregnancy...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

The Evolving Concept of Cryptogenic Stroke
This article discusses cryptogenic stroke and the results of recent randomized trials that can inform its evaluation and management. RECENT FINDINGS Most cryptogenic strokes appear embolic, leading to the term embolic stroke of undetermined source. It was previously thought that embolic stroke of undetermined source was a single, therapeutically relevant entity, the underlying sources of which would respond to anticoagulant therapy; however, two large randomized trials found no benefit with anticoagulation compared to antiplatelet therapy for secondary stroke prevention after embolic stroke of undetermined source. A sin...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Cerebral Small Vessel Disease
This article reviews the clinical significance and neuroimaging characteristics of cerebral small vessel disease and the impact on neurologic disease and current and potential therapeutic approaches. RECENT FINDINGS Cerebral small vessel disease is increasingly prevalent and highly heterogeneous in neuroimaging and clinical presentation. Small subcortical infarcts, lacunes, cerebral microbleeds, cortical microinfarcts, and white matter hyperintensity of presumed vascular origin represent the major neuroimaging markers of small vessel disease. Increasing small vessel disease burden is associated with risk of incident str...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Endovascular Treatment of Acute Ischemic Stroke
This article reviews the actual indications for mechanical thrombectomy in patients with acute ischemic stroke and how the opportunities for endovascular therapy can be expanded by using the concept of clinical-imaging or perfusion-imaging mismatch (as a surrogate for salvageable tissue) rather than time of ischemia. RECENT FINDINGS Six randomized controlled trials undoubtedly confirmed the benefits of using endovascular thrombectomy on the clinical outcome of patients with stroke with large vessel occlusion within 6 hours from symptom onset compared with those receiving only standard medical care. In a meta-analysis of...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Neuroimaging in Acute Stroke
This article describes how imaging can be used by physicians in diagnosing, determining prognosis, and making appropriate treatment decisions in a timely manner in patients with acute stroke. RECENT FINDINGS Advances in acute stroke treatment, including the use of endovascular thrombectomy in patients with large vessel occlusion and, more recently, of IV thrombolysis in an extended time window, have resulted in a paradigm shift in how imaging is used in patients with acute stroke. This paradigm shift, combined with the understanding that “time is brain,” means that imaging must be fast, reliable, and availab...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Update on Treatment of Acute Ischemic Stroke
This article provides an update on the state of the art of the treatment of acute ischemic stroke with particular emphasis on the indications for reperfusion therapy. RECENT FINDINGS In addition to the previously established indications for intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rtPA) within 4.5 hours of stroke symptom onset and endovascular therapy with mechanical thrombectomy for patients with large artery occlusion who can be treated within 6 hours of symptom onset, recent randomized controlled trials have now established new indications for emergency reperfusion in patients with ...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Epidemiology and Primary Prevention of Stroke
This article provides an update on the epidemiology and prevention of a first stroke. Risk factor modification plays a large role in stroke prevention. Strategies for early intervention, particularly for hypertension, are critical for reducing stroke morbidity and mortality. RECENT FINDINGS Because of the new criteria for hypertension, more people are now classified as hypertensive and can benefit from lifestyle or medical management. Direct oral anticoagulants have made it easier to safely treat patients with atrial fibrillation and are now considered first-line therapy for patients with an additional stroke risk facto...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

A Stroke Watershed
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: EDITOR’S PREFACE Source Type: research

Contributors
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: CONTRIBUTORS Source Type: research

Table of Contents
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: Table of Contents Source Type: research

Issue Overview
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - February 1, 2020 Category: Neurology Tags: ISSUE OVERVIEW Source Type: research

Key Points For Issue
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - February 1, 2020 Category: Neurology Tags: KEY POINTS FOR ISSUE Source Type: research

List of Abbreviations
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - February 1, 2020 Category: Neurology Tags: LIST OF ABBREVIATIONS Source Type: research