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Correction to: Clinical Practice Update Part I: Diagnosis and Treatment for Benign Paroxysmal Positional Vertigo
(Source: Current Treatment Options in Neurology)
Source: Current Treatment Options in Neurology - November 22, 2023 Category: Neurology Source Type: research
Correction to: Speech Language Pathology in the Neurocritical Care Unit
(Source: Current Treatment Options in Neurology)
Source: Current Treatment Options in Neurology - November 14, 2023 Category: Neurology Source Type: research
Epilepsy Treatment in Patients with Heart Disease
AbstractPurpose of reviewThis review highlights issues pertaining to the treatment of seizures in patients with cardiac disease. These fall into two categories: impacts upon the native disease — primarily an issue with coronary artery disease and arrhythmia — and drug interactions, which are important in all types of cardiac disease.Recent findingsA sizeable body of evidence indicates that enzyme-inducing anti-seizure medications (EIASMs) increase serum lipids and other serological and surrogate markers of vascular risk. A recent large epidemiologic study confirmed that patients treated with EIASMs are at significantly...
Source: Current Treatment Options in Neurology - November 6, 2023 Category: Neurology Source Type: research
Speech Language Pathology in the Neurocritical Care Unit
AbstractPurpose of reviewThe aim of this study is to review the scope of practice of speech language pathologists (SLPs) in the daily practice of neurocritical care.Recent findingsIn patients with aphasia, impairment-based or function-based language interventions improve outcomes. Augmentative and alternative communication devices can help certain patients with severely impaired speech production. After tracheostomy, one-way speaking valves can be placed either in-line with a ventilator or after weaning; it has been shown that earlier placement is associated with faster decannulation. Swallow screening, bedside swallow eva...
Source: Current Treatment Options in Neurology - October 9, 2023 Category: Neurology Source Type: research
Epilepsy Management in Transgender and Gender Diverse People
AbstractPurpose of reviewThe goal of this review is to outline important topics in epilepsy management for transgender and gender diverse individuals. Specifically, we describe the common gender-affirming hormone treatment regimens, how these changes in estrogens and androgens may affect seizure threshold and anti-seizure medications, and how anti-seizure medications may in turn impact hormone levels.Recent findingsAlthough data are mixed, most studies point to proconvulsant properties of estrogen and anticonvulsant properties of progesterone and testosterone, raising the possibility of an increased risk of breakthrough se...
Source: Current Treatment Options in Neurology - October 7, 2023 Category: Neurology Source Type: research
The Role of Pharmacy in Neurocritical Care
AbstractPurpose of reviewThis review presents the evolution of clinical pharmacy services in critical care and describes the roles of pharmacists specifically in the setting of the neurocritical care unit and the field of neurocritical care in general.Recent findingsSeveral studies show that clinical pharmacists in critical care are associated with reductions in mortality, ICU stay, medical costs, and adverse events. While many pharmacists are prolific in clinical research on drug therapy, data on outcomes for pharmacists practicing specifically in neurocritical care are not common. Recent guidelines on standards for neuro...
Source: Current Treatment Options in Neurology - October 5, 2023 Category: Neurology Source Type: research
Seizures in the Setting of COVID-19
AbstractPurpose of reviewThis review presents current available data relating to seizures in the context of COVID-19 infection from theorized pathophysiology to presentations and treatments. We also review the impact the COVID-19 pandemic has had on people with epilepsy (PWE) with special consideration of changes in healthcare access and COVID-19 vaccine.Recent findingsPWE are not more susceptible to contracting COVID-19 infection; however, recent data suggests PWE are a potential high-risk population for more severe symptoms and ICU admission. Given drug-drug interactions, caution should be advised when using certain trea...
Source: Current Treatment Options in Neurology - October 3, 2023 Category: Neurology Source Type: research
The Need for Continuity of Care in Neurocritical Care and Recovery
AbstractPurpose of reviewAfter discharge from the Neurological Intensive Care Unit (NICU), patients often have new functional limitations and comorbidities requiring ongoing supportive care. In this review, we discuss the current state across the care continuum and identify opportunities for improvement.Recent findingsPatients often transition through multiple care settings after discharge from the NICU. Disposition to SNF (skilled nursing facility) and IRF (inpatient rehabilitation facility) varies significantly based on insurance coverage and geography. Opportunities for improvement in care transitions from the hospital ...
Source: Current Treatment Options in Neurology - October 3, 2023 Category: Neurology Source Type: research
The A2F ICU Liberation Bundle in Neurocritical Care
AbstractPurpose of reviewThe A2F intensive care unit (ICU) liberation bundle is a multi-component management strategy that has been shown to improve hospital survival and reduce rates of delirium and ICU readmission. In this review, we aim to highlight the potential role of the A2F bundle in neurocritical care settings while further delineating its individual components.Recent findingsThe A2F bundle and its components are supported by a robust evidence base that continues to develop regarding the management of critically ill patients. Recent additions include the DEXACET trial, which found that scheduled intravenous acetam...
Source: Current Treatment Options in Neurology - October 2, 2023 Category: Neurology Source Type: research
Shared Decision-Making and Family Meetings in Neurocritical Care
AbstractPurpose of ReviewShared decision-making (SDM) can enhance communication between healthcare providers and families in neurocritical care units (neuroICUs). This review summarizes the current state of SDM and family meetings in neuroICUs and discusses interventions that can improve the involvement of patients ’ surrogates in the decision-making process.Recent FindingsSurrogates of critically ill patients often wish to be more involved in decision-making. Several interventions, including information leaflets, family support interventions, and decision aids, have been developed and tested in ICUs, with some tailored ...
Source: Current Treatment Options in Neurology - September 12, 2023 Category: Neurology Source Type: research
Recommendations for Family Presence at the Bedside in Neurocritical Care
AbstractPurpose of reviewThe purpose of this review is to summarize the latest evidence regarding family presence at the bedside in the neuro-ICU. Benefits, drawbacks, and recommendations are provided to support family members of persons receiving neurocritical care.Recent findingsFamily presence at the bedside can support positive outcomes for patients, family members, and health care staff. Recent findings suggest better satisfaction with care, reduced negative symptoms, and increased self-efficacy in families engaging in family-centered ICU care. The perceptions of health care staff regarding increased family presence a...
Source: Current Treatment Options in Neurology - September 8, 2023 Category: Neurology Source Type: research
Clinical Practice Update Part II: Considerations for Treatment and Management of Benign Paroxysmal Positional Vertigo
AbstractPurpose of reviewAlthough benign paroxysmal positional vertigo (BPPV) can be diagnosed and treated at bedside with positional testing and maneuvers, clinicians need to be aware of complications of maneuvers and factors that influence the treatment and education of BPPV. Appropriate integration of supplemental factors when managing BPPV will empower the clinician and may optimize treatment.Recent findingsWhen treating BPPV, clinicians need to be aware of pathologies that mimic BPPV, precautions when treating BPPV, complications of treatment maneuvers, and assistive devices used for treating BPPV. Understanding aspec...
Source: Current Treatment Options in Neurology - September 6, 2023 Category: Neurology Source Type: research
Clinical Practice Update Part I: Diagnosis and Treatment for Benign Paroxysmal Positional Vertigo
AbstractPurpose of reviewBenign paroxysmal positional vertigo (BPPV) can be diagnosed and treated at bedside with positional testing and maneuvers. Appropriate and timely recognition and treatment for BPPV can ameliorate symptoms of vertigo and spinning, reduce fall risk and healthcare costs, and minimize disability. Although medications may transiently reduce symptoms, they do not address the underlying pathology. Treatment typically includes the Epley or Semont maneuvers for posterior canal BPPV, the Gufoni or BBQ (Lempert) maneuvers for horizontal canal and the Yacovino or deep head hang maneuver for the anterior canal ...
Source: Current Treatment Options in Neurology - September 4, 2023 Category: Neurology Source Type: research
Treatment of Persistent Postural-Perceptual Dizziness (PPPD)
This article aims to review available and emerging treatment strategies for this prevalent functional neurological disorder and provides practical recommendations for personalising therapy.Recent FindingsAs our knowledge of the underlying causes of PPPD continues to grow, evidence for the best treatment approach is still limited but accumulating. Vestibular rehabilitation, cognitive-behavioural therapy (CBT), and serotonin reuptake inhibitors, alone or in combination, can be beneficial with similar treatment effects in reducing dizziness handicap scores. Newer treatments that have been explored include self-help programmes...
Source: Current Treatment Options in Neurology - August 21, 2023 Category: Neurology Source Type: research
Biomarker Defined Acute Optic Neuritis: A Review and Perspective
AbstractPurpose of reviewThis review provides a comprehensive summary of treatment options and management considerations for patients with acute inflammatory optic neuritis. A critical appraisal of the findings from landmark trials to the more recent studies is presented to provide a reference for diagnostic approaches, treatment options, and future research perspectives.Recent findingsThe Optic Neuritis Treatment Trial (ONTT) provides the best natural history study of optic neuritis and its relationship to remitting relapsing multiple sclerosis. In addition, the ONTT produced some unexpected and controversial results abou...
Source: Current Treatment Options in Neurology - August 15, 2023 Category: Neurology Source Type: research