Issue Overview
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 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, 2021 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, 2021 Category: Neurology Tags: LIST OF ABBREVIATIONS Source Type: research

Learning Objectives and Core Competencies
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: LEARNING OBJECTIVES AND CORE COMPETENCIES Source Type: research

Erratum
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 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, 2021 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, 2021 Category: Neurology Tags: SELF-ASSESSMENT AND CME Source Type: research

Self-assessment and cme
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: SELF-ASSESSMENT AND CME Source Type: research

False Claims Act Overview and Implications for Neurologists
The US Department of Health and Human Services Office of the Inspector General identifies the five most important federal fraud and abuse laws that are most applicable to physicians: the False Claims Act, the Anti-Kickback Statute, the Physician Self-Referral Law (Stark Law), the Exclusion Authorities, and the Civil Monetary Penalties Law (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: MEDICOLEGAL ISSUES Source Type: research

Spontaneous Intracranial Hypotension
This article reviews the clinical presentation, diagnosis, and treatment of spontaneous intracranial hypotension. RECENT FINDINGS The hallmark symptom of spontaneous intracranial hypotension is acute orthostatic headache; however, clinical presentations can be heterogeneous. New evidence shows that lumbar puncture is not always necessary or sufficient to establish the diagnosis. Some patients may have normal opening pressure, which suggests that insufficiency of CSF volume (hypovolemia) rather than CSF pressure might be the underlying mechanism. Several neuroimaging modalities can aid in diagnosis and localization o...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Clinic-based Procedures for Headache
PURPOSE OF REVIEW Headache disorders are common and disabling, and many therapies that are effective and safe are procedural. RECENT FINDINGS After pivotal clinical trials, onabotulinumtoxinA has become an established preventive therapy for chronic migraine; it is better tolerated than many other treatments and may be useful for other headache disorders. Peripheral nerve blocks, especially greater occipital nerve blocks, have amassed evidence from randomized trials in the acute and short-term preventive treatment of migraine and cluster headache. Trigger point injections and sphenopalatine ganglion blocks have r...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Headache in Children and Adolescents
This article reviews the approach to a child or adolescent with headache, the criteria for common diagnoses, and the evidence base for treatments. RECENT FINDINGS The guidelines for acute and preventive treatment of migraine were updated in 2019. These guidelines summarize the available evidence and outline the questions that should be addressed in future research. The US Food and Drug Administration (FDA) approval of several new classes of drugs and devices to treat adult migraine in the past few years has resulted in ongoing or planned pediatric trials. SUMMARY Headache is a common symptom in children, and ...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Headache in Women
PURPOSE OF REVIEW Women are greatly overrepresented among patients seeking treatment for symptoms of headache pain in general and migraine in particular. Understanding the presentation of headache in women in relation to hormonal changes both during the menstrual cycle and throughout the life span is essential for appropriate diagnosis and treatment. RECENT FINDINGS Although perimenstrual migraine attacks are generally without aura, the diagnosis of migraine with aura has been added to the headache classification for menstrual migraine to account for women with the diagnosis of migraine with aura who experience ...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Cranial Neuralgias
This article discusses the differential diagnosis, evaluation, and management of trigeminal neuralgia and reviews other neuralgias of the head and neck, including those that contribute to neuralgic ear pain. RECENT FINDINGS Most cases of trigeminal neuralgia are related to vascular compression, a demyelinating plaque, or a compressive mass affecting the trigeminal nerve. However, recent studies have shown that up to 11% of patients have a family history of trigeminal neuralgia, suggesting that some patients may have a genetic predisposition to demyelination or nerve hyperexcitability. In these patients, trigeminal n...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Other Primary Headache Disorders
This article provides an overview of a diverse group of primary headache disorders that are categorized in the International Classification of Headache Disorders, 3rd Edition (ICHD-3), as “other primary headache disorders.” This article provides clinicians with a distilled understanding of the diagnoses and their epidemiology, pathophysiology, and management. RECENT FINDINGS Cough-induced headache requires neuroimaging to exclude posterior fossa pathology and recently has been reported as a common symptom in patients with CSF-venous fistula. Clinical overlap is observed between patients with primary exer...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Cluster Headache and Other Trigeminal Autonomic Cephalalgias
PURPOSE OF REVIEW The trigeminal autonomic cephalalgias (TACs) are relatively rare, but they represent a distinct set of syndromes that are important to recognize. Despite their unique features, TACs often go undiagnosed or misdiagnosed for several years, leading to unnecessary pain and suffering. A significant proportion of TAC presentations may have secondary causes. RECENT FINDINGS The underlying pathophysiology of TACs is likely rooted in hypothalamic dysfunction and derangements in the interplay of circuitry involving trigeminovascular, trigeminocervical, trigeminoautonomic, circadian, and nociceptive syste...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Preventive Migraine Treatment
This article provides an overview of preventive interventions for migraine, including when to start and how to choose a treatment, pharmacologic options (both older oral treatments and new monoclonal antibodies to calcitonin gene-related peptide [CGRP] or its receptor), nonpharmacologic treatment such as neuromodulation, and preventive treatment of refractory migraine. RECENT FINDINGS The migraine preventive treatment landscape has been transformed by the development of monoclonal antibodies targeting CGRP or its receptor. These treatments, which are given subcutaneously or intravenously monthly or quarterly, have h...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Acute Migraine Treatment
This article discusses acute migraine therapy, focusing on best-level evidence. (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Pathophysiology of Migraine
This article summarizes the current understanding of the pathophysiology of migraine, including some controversial aspects of the underlying mechanisms of the disorder. RECENT FINDINGS Recent functional neuroimaging studies focusing on the nonpainful symptoms of migraine have identified key areas of the central nervous system implicated in the early phases of a migraine attack. Clinical studies of spontaneous and provoked migraine attacks, together with preclinical studies using translational animal models, have led to a better understanding of the disease and the development of disease-specific and targeted therapi...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Diagnosing Secondary and Primary Headache Disorders
This article provides a systematic diagnostic approach to the patient with headache. RECENT FINDINGS The vast majority of patients presenting with headache in clinical practice have a primary headache disorder. The most common primary headache disorder in clinical practice is overwhelmingly migraine. Unfortunately, a substantial proportion of patients with migraine do not receive an accurate diagnosis. In addition, the clinical features of migraine overlap with secondary causes of headache, making a careful history and deliberative evaluation for warning symptoms or signs of a secondary headache disorder of paramoun...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

No Longer a Headache: Accessing Continuum on the Go
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2021 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, 2021 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, 2021 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, 2021 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, 2021 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, 2021 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, 2021 Category: Neurology Tags: LEARNING OBJECTIVES AND CORE COMPETENCIES Source Type: research

Erratum
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2021 Category: Neurology Tags: ERRATUM 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, 2021 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, 2021 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, 2021 Category: Neurology Tags: SELF-ASSESSMENT AND CME Source Type: research

Tinnitus, Hyperacusis, Otalgia, and Hearing Loss
This article reviews the causes of tinnitus, hyperacusis, and otalgia, as well as hearing loss relevant for clinicians in the field of neurology. RECENT FINDINGS Important causes of unilateral and bilateral tinnitus are discussed, including those that are treatable or caused by serious structural or vascular causes. Concepts of hyperacusis and misophonia are covered, along with various types of neurologic disorders that can lead to pain in the ear. Hearing loss is common but not always purely otologic. SUMMARY Tinnitus and hearing loss are common symptoms that are sometimes related to a primary neurologic dis...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Selected Otologic Disorders Causing Dizziness
This article details updated clinical presentations and current treatment paradigms of the common otologic disorders that may present to the neurologist for vertigo, including Ménière disease, superior semicircular canal dehiscence syndrome, perilymphatic fistula, barotrauma, cholesteatoma, Ramsay Hunt syndrome, enlarged vestibular aqueduct syndrome, and autoimmune inner ear disease including Cogan syndrome. RECENT FINDINGS The recent data on modern imaging techniques with three-dimensional delayed IV contrast in Ménière disease, findings on the clinical and testing parameters to diagnose...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Vertigo Related to Central Nervous System Disorders
This article provides an overview of the numerous causes of vertigo and dizziness that are due to central nervous system (CNS) pathology and guides clinicians in formulating a differential diagnosis and treating patients with CNS causes of vertigo. RECENT FINDINGS Specific autoimmune vestibulocerebellar syndromes may now be tested for, and this article discusses the antibodies known to cause such syndromes. Superficial siderosis can be more accurately diagnosed with imaging studies, and treatment using iron chelation has recently been studied but has not yet been established as an effective treatment. Central autono...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Chronic Dizziness
This article covers distinct causes of chronic dizziness including persistent postural perceptual dizziness, mal de débarquement syndrome, motion sickness and visually induced motion sickness, bilateral vestibulopathy, and persistent dizziness after mild concussion. RECENT FINDINGS To date, none of the disorders above has a cure but are considered chronic syndromes with fluctuations that are both innate and driven by environmental stressors. As such, the mainstay of therapy for chronic disorders of dizziness involves managing factors that exacerbate symptoms and adding vestibular rehabilitation or cognitive-b...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Acute Vestibular Syndrome
This article provides a practical approach to acute vestibular syndrome while highlighting recent research advances. RECENT FINDINGS Acute vestibular syndrome is defined as sudden-onset, continuous vertigo lasting longer than 24 hours with associated nausea and vomiting, all of which are worsened with head movement. Acute vestibular syndrome is provoked by a variety of central and peripheral causes, the most common of which are vestibular neuritis and acute stroke (posterior circulation). A clinical approach focusing on timing, associated history, and ocular motor findings can improve diagnostic accuracy and is more...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Episodic Spontaneous Dizziness
PURPOSE OF REVIEW Conditions causing recurrent spontaneous episodes of dizziness or vertigo span several medical specialties, making it challenging for clinicians to gain confidence in evaluating and managing the spectrum of episodic vestibular disorders. Patients are often asymptomatic and have normal examinations at the time of evaluation. Thus, diagnosis depends heavily on eliciting key features from the history. Overreliance on symptom quality descriptions commonly leads to misdiagnosis. The goal of this article is to provide the reader with a straightforward approach to the diagnosis and management of conditions t...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Episodic Positional Dizziness
This article provides a summary of the evaluation and treatment of patients presenting with episodic positional dizziness. RECENT FINDINGS Positional components are nearly ubiquitous among diagnoses of dizziness, so it can be challenging to classify patients with episodic positional dizziness simply based on the history of present illness. Overreliance on the presence of a report of positional components has likely resulted in misapplication or misinterpretation of positional testing and negative experiences with maneuvers to treat positional dizziness. The prototypical episodic positional dizziness disorder is beni...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Vestibular Testing
This article introduces readers to core concepts, as well as recent advances, in bedside and instrumented vestibular assessments. RECENT FINDINGS Vestibular testing has improved immensely in the past 2 decades. While history and bedside testing is still the primary method of differential diagnosis in patients with dizziness, advances in technology such as the ocular vestibular-evoked myogenic potential test for superior canal dehiscence and the video head impulse test for vestibular neuritis have capabilities that go far beyond the bedside examination. Current vestibular testing now allows clinicians to test all fiv...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Approach to the History and Evaluation of Vertigo and Dizziness
This article reviews a method of obtaining the medical history of patients presenting with dizziness, vertigo, and imbalance. By combining elements of the history with examination, the goal is to identify patterns and an effective differential diagnosis for this group of patients to help lead to an accurate diagnosis. RECENT FINDINGS Studies over the past dozen years have changed the historical approach to patients with dizziness from one based primarily on how the patient describes the sensation of dizziness. This older approach can lead to misdiagnosis, so a preferred method puts greater emphasis on whether the di...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Discovering Your Patient’s Inner Ear
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2021 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, 2021 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, 2021 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, 2021 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, 2021 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, 2021 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 - February 1, 2021 Category: Neurology Tags: LEARNING OBJECTIVES AND CORE COMPETENCIES Source Type: research

Erratum
No abstract available (Source: CONTINUUM: Lifelong Learning in Neurology)
Source: CONTINUUM: Lifelong Learning in Neurology - February 1, 2021 Category: Neurology Tags: ERRATUM 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 - February 1, 2021 Category: Neurology Tags: SELF-ASSESSMENT AND CME Source Type: research