Neurosurgical Infections
Semin Neurol 2019; 39: 507-514 DOI: 10.1055/s-0039-1693107Patients in the neurointensive care unit often undergo life-saving neurosurgical interventions that can be associated with serious complications. Infection is a common and sometimes fatal complication of such procedures. Infection may occur not only in the setting of major cranial and spinal surgery, but also with common minor procedures that utilize neurosurgical devices, such as placement of external ventricular drains, ventriculoperitoneal shunts, and deep brain stimulators. In this article, we review the epidemiology and microbiology of these infections, and dis...
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Sader, Elie Moore, Justin Cervantes-Arslanian, Anna M. Tags: Review Article Source Type: research

Neurological Complications of Endocarditis: A Multidisciplinary Review with Focus on Surgical Decision Making
Semin Neurol 2019; 39: 495-506 DOI: 10.1055/s-0039-1688826Infective endocarditis (IE) is a systemic disease with many potential neurologic manifestations including ischemic and hemorrhagic strokes, cerebral microbleeding, infectious intracranial aneurysms, meningitis, brain abscesses, and encephalopathy. The majority of left-sided (heart) IE patients have brain lesions that may alter management decisions, warranting the systematic use of magnetic resonance imaging. Many patients require surgical treatment of valvular disease, and central nervous system lesions weigh into decision making. Data regarding the timing of surger...
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Carneiro, Thiago Santos Awtry, Eric Dobrilovic, Nikola Fagan, Maura A. Kimmel, Simeon Weinstein, Zoe M. Cervantes-Arslanian, Anna M. Tags: Review Article Source Type: research

Infectious Etiologies of Stroke
Semin Neurol 2019; 39: 482-494 DOI: 10.1055/s-0039-1687915Central nervous system (CNS) infections are a frequently underappreciated potential etiology of cerebrovascular disease. Highlighted in this review are a selection of infectious agents that lead to cerebrovascular complications through various mechanisms including multifocal vasculopathy, focal infiltrative vasculitis and vasospasm, and direct vessel wall invasion and thrombus formation. Diagnosis of stroke due to underlying CNS infection requires a high index of clinical suspicion and careful consideration of neuroimaging, serum, and cerebrospinal fluid studies in ...
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Shulman, Julie G. Cervantes-Arslanian, Anna M. Tags: Review Article Source Type: research

Infectious Myelitis
Semin Neurol 2019; 39: 472-481 DOI: 10.1055/s-0039-1688923Myelitis refers to inflammation of the spinal cord which can result in a spectrum of neurologic impairment. Infectious pathogens are an important etiologic category, and can result in myelitis through direct pathogenic effect or through immune-mediated parainfection; this review focuses on the former category. The spectrum of clinical manifestations is summarized and a diagnostic workup provided to aid clinicians in developing an approach to patients presenting with symptoms suggestive of infectious myelitis. This is followed by an overview of the important viral, b...
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Asundi, Archana Cervantes-Arslanian, Anna M. Lin, Nina H. Barbosa, Felipe Tags: Review Article Source Type: research

Neurological Complications of Leprosy
Semin Neurol 2019; 39: 462-471 DOI: 10.1055/s-0039-1687884Leprosy is a challenging international health concern. Despite tremendous efforts in reducing worldwide disease prevalence in the past decades, some countries remain endemic and are plagued by high levels of disability. The neurological complications of leprosy are varied and complex, with current research focused on evaluating tools for earlier diagnosis of neuropathy, especially in resource-limited countries. While treatment with multidrug therapy is highly effective, active research aims to simplify regimens to improve adherence, minimize adverse effects, and pre...
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Lau, K. H. Vincent Tags: Review Article Source Type: research

Neurotuberculosis: A Clinical Review
Semin Neurol 2019; 39: 456-461 DOI: 10.1055/s-0039-1687840In September 2018, the United Nations General Assembly held the first ever meeting to discuss the global epidemic of tuberculosis (TB) and adopted a political declaration titled “United to end tuberculosis: an urgent global response to a global epidemic.” The timing of the meeting was prescient but overdue since Mycobacterium tuberculosis surpassed the human immunodeficiency virus as the world's leading infectious killer in 2014. Infection of the central nervous system by Mycobacterium tuberculosis, herein referred to as neurotuberculosis, is the most fe...
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Chin, Jerome H. Tags: Review Article Source Type: research

Neurosyphilis
This article reviews the clinical presentation, diagnosis, and treatment of neurosyphilis, and it addresses the controversy regarding the role of lumbar puncture early in the course of infection. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Gonzalez, Hemil Koralnik, Igor J. Marra, Christina M. Tags: Review Article Source Type: research

A Neurologist's View of Lyme Disease and Other Tick-Borne Infections
Semin Neurol 2019; 39: 440-447 DOI: 10.1055/s-0039-1692143Tick-borne infections—including tick-borne encephalitis viruses, represented in the United States by rare infections with Powassan and deer tick viruses, and more often Lyme disease—are of increasing importance to neurologists. Lyme neuroborreliosis (LNB) causes all or part of a triad including meningitis, radiculoneuritis, and cranial neuritis. Rarely, parenchymal brain and spinal cord involvement occur, with focal findings on examination and magnetic resonance imaging (MRI). LNB diagnosis requires plausible exposure, objective evidence of nervous syste...
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Halperin, John J. Tags: Review Article Source Type: research

Prion Disease
This article will review the pathophysiology, genetics, clinical presentations, and diagnostic challenges in patients with prion disease. Case discussions, images, and tables will be used to highlight important characteristics of prion disease and prion mimics. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Baldwin, Kelly J. Correll, Cynthia M. Tags: Review Article Source Type: research

Five Emerging Neuroinvasive Arboviral Diseases: Cache Valley, Eastern Equine Encephalitis, Jamestown Canyon, Powassan, and Usutu
Semin Neurol 2019; 39: 419-427 DOI: 10.1055/s-0039-1687839There are many arthropod-borne viruses (arboviruses) capable of neuroinvasion, with West Nile virus being one of the most well known. In this review, we highlight five rarer emerging or reemerging arboviruses capable of neuroinvasion: Cache Valley, eastern equine encephalitis, Jamestown Canyon, Powassan, and Usutu viruses. Cache Valley and Jamestown Canyon viruses likely circulate throughout most of North America, while eastern equine encephalitis and Powassan viruses typically circulate in the eastern half. Usutu virus is not currently circulating in North America,...
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Gill, Christine M. Beckham, J. David Piquet, Amanda L. Tyler, Kenneth L. Pastula, Daniel M. Tags: Review Article Source Type: research

Neuroinfectious Disease, Part 2
Semin Neurol 2019; 39: 417-418 DOI: 10.1055/s-0039-1696637 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Cervantes-Arslanian, Anna M. Tags: Preface Source Type: research

Anna M. Cervantes-Arslanian, MD
Semin Neurol 2019; 39: 415-416 DOI: 10.1055/s-0039-1696677 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - September 18, 2019 Category: Neurology Authors: Greer, David M. Tags: Introduction to the Guest Editor Source Type: research

Neurologic Infections in Travelers
Semin Neurol 2019; 39: 399-414 DOI: 10.1055/s-0039-1688914This review will provide an outline of the neurological complications of specific parasitic, bacterial, and viral infectious diseases that can affect the international traveler. We will discuss the epidemiology, life cycle, ecology, clinical manifestation, diagnosis, treatment, and prevention. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - August 2, 2019 Category: Neurology Authors: Sharma, Malveeka Zunt, Joseph R. Tags: Review Article Source Type: research

Treatment of Central Nervous System Manifestations of HIV in the Current Era
Semin Neurol 2019; 39: 391-398 DOI: 10.1055/s-0039-1688915Treatment of neurological, neurocognitive, and neuropsychiatric impairment in the setting of human immunodeficiency virus (HIV) infection remains a complex problem, given several possible mechanisms of pathogenesis. The etiology must be determined based on clinical judgment and objective evidence, including cerebrospinal fluid (CSF) data from lumbar puncture and neuroimaging information from magnetic resonance imaging, when available and indicated. Other neuroinfectious etiologies must be ruled out, including central nervous system (CNS) opportunistic infections. HI...
Source: Seminars in Neurology - August 2, 2019 Category: Neurology Authors: Handoko, Ryan Spudich, Serena Tags: Review Article Source Type: research

Central Nervous System Opportunistic Infections
Semin Neurol 2019; 39: 383-390 DOI: 10.1055/s-0039-1687842Opportunistic infections of the central nervous system are classically associated with immunosuppression arising from infection with human immunodeficiency virus and with various hematologic malignancies. However, over the past few years, they are increasingly associated with transplantation and various immunosuppressive treatments used to treat autoimmune diseases. They cause significant morbidity and mortality and remain a diagnostic challenge due to the absence of typical signs and symptoms of infection and mimicry by various noninfectious causes. The pathogens a...
Source: Seminars in Neurology - August 2, 2019 Category: Neurology Authors: Agnihotri, Shruti P. Tags: Review Article Source Type: research

Herpesvirus Infections of the Central Nervous System
Semin Neurol 2019; 39: 369-382 DOI: 10.1055/s-0039-1687837There are over 200 herpesvirus species, of which 10 affect humans. Each of these 10 herpesviruses has a unique clinical syndrome, but common to all is their ability to cause infection and pathology in the central nervous system. In this article, we discuss the epidemiology, clinical presentation, diagnostic modalities, treatment, sequelae, and availability of vaccination of each of the following herpesviruses: herpes simplex virus 1 and 2, varicella zoster virus, human cytomegalovirus, human herpesvirus 6A, 6B, and 7, Epstein–Barr virus, human herpesvirus 8, a...
Source: Seminars in Neurology - August 2, 2019 Category: Neurology Authors: Bharucha, Tehmina Houlihan, Catherine F. Breuer, Judith Tags: Review Article Source Type: research

Parasitic Infections of the Nervous System
This article reviews parasitic pathogens causing neurological morbidity and mortality, including an extensive list of less common parasitic infections of the human nervous system. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - August 2, 2019 Category: Neurology Authors: Garcia, Hector H. Nath, Avindra Del Brutto, Oscar H. Tags: Review Article Source Type: research

Fungal Infections of the Central Nervous System
This article will describe the epidemiology, clinical presentations, diagnostic approach and therapeutic interventions for fungal infections in the central nervous system. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - August 2, 2019 Category: Neurology Authors: Jia, Dan Tong Thakur, Kiran Tags: Review Article Source Type: research

Bacterial Infections of the Central Nervous System
Semin Neurol 2019; 39: 334-342 DOI: 10.1055/s-0039-1693159Acute bacterial meningitis and spinal epidural abscess are neurological emergencies. Acute bacterial meningitis may present with symptoms as nonspecific as headache and fever, but rapid progression to an altered level of consciousness is not unusual. Spinal epidural abscess manifests initially as back pain, followed by radicular pain, then weakness, and finally paraplegia. Brain abscess may initially present only with headache, or as a new-onset seizure or with a focal neurological deficit. Bacterial infections of the central nervous system require emergent diagnosi...
Source: Seminars in Neurology - August 2, 2019 Category: Neurology Authors: LaPenna, Paul A. Roos, Karen L. Tags: Review Article Source Type: research

Imaging of Intracranial Infections
Semin Neurol 2019; 39: 322-333 DOI: 10.1055/s-0039-1693161Central nervous system (CNS) infections are a major source of morbidity and mortality despite the remarkable progress in prevention and treatment of infectious disease. Because of the difficulty of direct tissue sampling, imaging plays a crucial role in detecting, diagnosing, and monitoring the therapeutic response of CNS infections. An accurate diagnosis in CNS infections is especially rewarding, given the availability of potential effective antimicrobials.Bacterial, viral, fungal, and parasitic infections may affect the brain and/or its meningeal coverings, and ca...
Source: Seminars in Neurology - August 2, 2019 Category: Neurology Authors: Abdalkader, Mohamad Xie, Juliana Cervantes-Arslanian, Anna Takahashi, Courtney Mian, Asim Z. Tags: Review Article Source Type: research

Imaging in Encephalitis
Semin Neurol 2019; 39: 312-321 DOI: 10.1055/s-0039-1687838Despite recent advances in diagnostic and therapeutic modalities for infectious and autoimmune encephalitis, the management of patients with suspected or confirmed encephalitis poses a great challenge to physicians. Neuroimaging, including magnetic resonance imaging (MRI) and positron emission tomography (PET) scanning, can play a crucial role in substantiating the diagnosis of encephalitis and eliminating clinical mimics of encephalitis from consideration. Moreover, characteristic neuroimaging patterns can aid in defining specific infectious and autoimmune etiologi...
Source: Seminars in Neurology - August 2, 2019 Category: Neurology Authors: Venkatesan, Arun Jagdish, Balaji Tags: Review Article Source Type: research

Diagnostic Testing in Central Nervous System Infection
Semin Neurol 2019; 39: 297-311 DOI: 10.1055/s-0039-1688441Patients with central nervous system (CNS) infection experience very high levels of morbidity and mortality, in part because of the many challenges inherent to the diagnosis of CNS infection and identification of a causative pathogen. The clinical presentation of CNS infection is nonspecific, so clinicians must often order and interpret many diagnostic tests in parallel. This can be a daunting task given the large number of potential pathogens and the availability of different testing modalities. Here, we review traditional diagnostic techniques including Gram stain...
Source: Seminars in Neurology - August 2, 2019 Category: Neurology Authors: Kanjilal, Sanjat Cho, Tracey A. Piantadosi, Anne Tags: Review Article Source Type: research

Neuroinfectious Disease, Part 1
Semin Neurol 2019; 39: 295-296 DOI: 10.1055/s-0039-1693686 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - August 2, 2019 Category: Neurology Authors: Cervantes-Arslanian, Anna M. Tags: Preface Source Type: research

Anna M. Cervantes-Arslanian, MD
Semin Neurol 2019; 39: 293-294 DOI: 10.1055/s-0039-1692163 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - August 2, 2019 Category: Neurology Authors: Greer, David M. Tags: Introduction to the Guest Editor Source Type: research

A Decision-Analytic Approach to Addressing the Evidence About Football and Chronic Traumatic Encephalopathy
Semin Neurol DOI: 10.1055/s-0039-1688484Doubts can be raised about almost any assertion that a particular exposure can lead to an increase in a given adverse health effect. Even some of the most well-accepted causal associations in public health, such as that linking cigarette smoking to increased lung cancer risk, have intriguing research questions remaining to be answered. The inquiry whether an exposure causes a disease is never wholly a yes/no question but ought to follow from an appraisal of the weight of evidence supporting the positive conclusion in light of any coherent theories casting doubt on this evidence and t...
Source: Seminars in Neurology - July 16, 2019 Category: Neurology Authors: Brand, Kevin P. Finkel, Adam M. Tags: Review Article Source Type: research

Autoimmune Encephalitides and Rapidly Progressive Dementias
This article focuses on the growing field of autoimmune encephalitis (AE) as it pertains to the differential diagnostic considerations in a work-up for RPD. Understanding clues in the history and examination is the first step in identifying patients with a potential autoimmune cause for RPD. While testing for infectious and toxic-metabolic etiologies is commonly preformed, it is necessary to consider early ancillary testing for AE in appropriate cases of RPD. Autoantibody testing in the spinal fluid and serum, brain imaging, and electroencephalography all form the first line of investigations for AE. Treatment options and ...
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Wesley, Sarah F. Ferguson, Damien Tags: Review Article Source Type: research

Parkinson's Disease Dementia and Lewy Body Disease
Semin Neurol 2019; 39: 274-282 DOI: 10.1055/s-0039-1678579Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PD-D) are Lewy body-related neurodegenerative disorders sharing common clinical and neuropathological findings. The clinical features of both conditions include cognitive impairment, behavioral symptoms, autonomic dysfunction, sleep disorders, and parkinsonism. The cognitive profile of both disorders is characterized by particularly severe deficits in executive and visuospatial functions as well as attention. Clinical differentiation between DLB and PD-D is based on an arbitrary distinction between th...
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Sezgin, Mine Bilgic, Basar Tinaz, Sule Emre, Murat Tags: Review Article Source Type: research

Rare Tauopathies
Semin Neurol 2019; 39: 264-273 DOI: 10.1055/s-0039-1678584Tauopathies are rare neurodegenerative disorders related to microtubule-associated protein tau, which functions to stabilize microtubules. Pathological changes caused by overexpression or hyperphosphorylation of tau lead to the disengagement of tau from microtubules and accumulation of toxic intracellular inclusions. Tau pathology is the underlying mechanism for several sporadic and genetic disorders. These are collectively known as tauopathies. Each tauopathy is differentiated from others by its neuropathological features such as the presence of specific isoforms o...
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Ali, Farwa Josephs, Keith Tags: Review Article Source Type: research

Frontotemporal Dementia: A Clinical Review
Semin Neurol 2019; 39: 251-263 DOI: 10.1055/s-0039-1683379Frontotemporal dementias are a clinically, neuroanatomically, and pathologically diverse group of diseases that collectively constitute an important cause of young-onset dementia. Clinically, frontotemporal dementias characteristically strike capacities that define us as individuals, presenting broadly as disorders of social behavior or language. Neurobiologically, these diseases can be regarded as “molecular nexopathies,” a paradigm for selective targeting and destruction of brain networks by pathogenic proteins. Mutations in three major genes collectiv...
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Sivasathiaseelan, Harri Marshall, Charles R. Agustus, Jennifer L. Benhamou, Elia Bond, Rebecca L. van Leeuwen, Janneke E. P. Hardy, Chris J. D. Rohrer, Jonathan D. Warren, Jason D. Tags: Review Article Source Type: research

Vascular Cognitive Disorder
Semin Neurol 2019; 39: 241-250 DOI: 10.1055/s-0039-1678582The term vascular cognitive disorder (VCD) refers to a heterogeneous group of disorders in which the primary feature is cognitive impairment attributable to cerebrovascular disease (CVD). This includes not only vascular dementia (VaD) but also cognitive impairment of insufficient severity to meet diagnostic criteria for dementia. VCD is recognized as the second most common cause of dementia after Alzheimer's disease (AD), but prevalence rates vary widely according to the diagnostic criteria employed. There have been recent attempts to standardize diagnostic criteria...
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Paradise, Matt B. Sachdev, Perminder S. Tags: Review Article Source Type: research

Current and Future Treatments in Alzheimer's Disease
Semin Neurol 2019; 39: 227-240 DOI: 10.1055/s-0039-1678581The foundation of current Alzheimer's disease (AD) treatment involves pharmacological and nonpharmacological management and care planning predicated on patient-centered psychoeducation, shared goal-setting, and decision-making forged by a strong triadic relationship between clinician and the patient-caregiver dyad. Food and Drug Administration (FDA) approved AD medications, cholinesterase-inhibitors (ChEIs), and the N-methyl-d-aspartate (NMDA) antagonist memantine, when utilized as part of a comprehensive care plan, while generally considered symptomatic medications...
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Atri, Alireza Tags: Review Article Source Type: research

Alzheimer's Disease Including Focal Presentations
Semin Neurol 2019; 39: 213-226 DOI: 10.1055/s-0039-1681041Alzheimer's disease (AD) is the commonest neurodegenerative disease and the most frequent cause of dementia. It affects 30 million people worldwide. Current research criteria focus on biomarkers' status for amyloid and tau using positron emission tomography and cerebrospinal fluid analysis, independent of clinical status. Current epidemiological data, which mostly rely on biomarker-undetermined AD cases, have highlighted ApoE4 and age as the main risk factors. Rare autosomal dominant mutations also account for a small fraction of early-onset AD. The main clinical ph...
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Villain, Nicolas Dubois, Bruno Tags: Review Article Source Type: research

Interpretation of Biomarker Data in Diagnosis of Primary Dementias
Semin Neurol 2019; 39: 200-212 DOI: 10.1055/s-0039-1683380In the last few years, an improved understanding of dementia biomarkers has significantly increased the diagnostic accuracy for dementias. The National Institutes of Health Biomarkers Definitions Working Group defines a biomarker as “a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention.” In the field of dementia, a biomarker is a biological measure pointing to a specific dementing pathology. Dementia biomarkers may also se...
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Salardini, Arash Tags: Review Article Source Type: research

Neuroimaging in Dementias
Semin Neurol 2019; 39: 188-199 DOI: 10.1055/s-0039-1678580Dementia is a global health issue, the burden of which will worsen with an increasingly aging population. Alzheimer's disease (AD) is the most common dementia, with 50 to 60% of all dementias attributable to AD alone, while the rest are mostly due to frontotemporal lobar dementia, dementia with Lewy bodies, Parkinson's disease dementia, and vascular dementia. Diagnosis of dementias is made clinically with the aid of other testing modalities including neuroimaging. While the role of imaging has traditionally been to exclude reversible causes of dementia, positron emi...
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Mahalingam, Sowmya Chen, Ming-Kai Tags: Review Article Source Type: research

A Multifactor Approach to Mild Cognitive Impairment
Semin Neurol 2019; 39: 179-187 DOI: 10.1055/s-0039-1678585Mild cognitive impairment (MCI) represents an intermediate stage between normal cognition and dementia. Individuals with MCI are at increased risk of conversion to dementia, and the rate of progression of MCI to dementia is dependent on age, gender, and education. MCI may be diagnosed using neuropsychological criteria using cut-offs representing decrements in cognition, or using criteria to assess for a decline in functional status. The ability to determine the status of dementia-related biomarkers has allowed for better staging and prognostication in different form...
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Qarni, Taha Salardini, Arash Tags: Review Article Source Type: research

A Comprehensive Update on Treatment of Dementia
Semin Neurol 2019; 39: 167-178 DOI: 10.1055/s-0039-1683408Treatment of dementias represents an important but relatively neglected part of neurological care of the elderly population. Individual therapeutic interventions may make only small changes to the quality of life of individuals afflicted with dementia, but when used in combination these interventions synergize and can make a significant difference. Additionally, given the societal scale of the problem of dementia care, the overall impact, in economic and sociological terms, of such therapies is of consequence. Presently there are no disease-modifying treatments for ...
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Tisher, Annya Salardini, Arash Tags: Review Article Source Type: research

An Overview of Primary Dementias as Clinicopathological Entities
Semin Neurol 2019; 39: 153-166 DOI: 10.1055/s-0039-1683445Dementia is a state of cognitive dysfunction which leads to functional decline. It is a syndrome caused by several medical and neurological causes, but most cases of dementia are due to “primary dementias.” Primary dementias are neurological diseases whose manifestations are predominantly cognitive. Most primary dementias are caused by neurodegenerative proteinopathies where an accumulation of misfolded proteins leads to neuronal loss, neuroinflammation and glial reaction. Each proteinopathy is characterized by the type of protein implicated in its patho...
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Salardini, Arash Tags: Review Article Source Type: research

Dementia
Semin Neurol 2019; 39: 151-152 DOI: 10.1055/s-0039-1685173 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Salardini, Arash Tags: Preface Source Type: research

Arash Salardini, MBBS, BSc
Semin Neurol 2019; 39: 149-150 DOI: 10.1055/s-0039-1685174 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - March 29, 2019 Category: Neurology Authors: Greer, David M. Tags: Introduction to the Guest Editor Source Type: research

Wilderness Neurology
Semin Neurol 2019; 39: 137-148 DOI: 10.1055/s-0038-1676994The study of wilderness medicine is within the scope of medical care in the austere environment and addresses medicine as practiced in the setting of delayed access to definitive medical care, hostile environment, limited equipment, and inherent risks to the patient and/or rescuers. Part of this topic includes the care of patients with neurologic illness and/or injury.We will address the five most important skills of a wilderness medicine professional: decision making, prevention, preparation, protocol development, and education by applying the principles to select ...
Source: Seminars in Neurology - February 11, 2019 Category: Neurology Authors: Schlein, Sarah M. Marcolini, Paul G. Marcolini, Evie G. Tags: Review Article Source Type: research

Movement Disorders Emergencies
Semin Neurol 2019; 39: 125-136 DOI: 10.1055/s-0038-1677050Many acute and potentially life-threatening medical conditions have hyperkinetic or hypokinetic movement disorders as their hallmark. Here we review the clinical phenomenology, and diagnostic principles of neuroleptic malignant syndrome, malignant catatonia, serotonin syndrome, Parkinsonism hyperpyrexia, acute parkinsonism, acute chorea-ballism, drug-induced dystonia, and status dystonicus. In the absence of definitive lab tests and imaging, only a high index of clinical suspicion, awareness of at-risk populations, and variations in clinical presentation can help wi...
Source: Seminars in Neurology - February 11, 2019 Category: Neurology Authors: Rajan, Suraj Kaas, Bonnie Moukheiber, Emile Tags: Review Article Source Type: research

Acute Manifestations of Neuromuscular Disease
This article reviews neuromuscular emergencies by localization in the peripheral nervous system of the underlying disorder, as well as the identification and management of neuromuscular respiratory failure. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - February 11, 2019 Category: Neurology Authors: Edmundson, Christyn Bird, Shawn J. Tags: Review Article Source Type: research

Functional (Psychogenic) Neurological Disorders: Assessment and Acute Management in the Emergency Department
Semin Neurol 2019; 39: 102-114 DOI: 10.1055/s-0038-1676844Functional neurological disorders (FND) are complex and prevalent neuropsychiatric conditions. Importantly, some patients with FND develop acute onset symptoms requiring emergency department (ED) evaluations. Historically, FND was a “rule-out” diagnosis, making assessment and management in the ED difficult. While the rapid triage of potential neurological emergencies remains the initial task, advancements have altered the approach to FND. FND is now a “rule-in” diagnosis based on validated neurological examination signs and semiological featu...
Source: Seminars in Neurology - February 11, 2019 Category: Neurology Authors: Anderson, Jordan R. Nakhate, Vihang Stephen, Christopher D. Perez, David L. Tags: Review Article Source Type: research

Emergency Evaluation and Management of Encephalitis and Myelitis in Adults
Semin Neurol 2019; 39: 082-101 DOI: 10.1055/s-0038-1676845Infection of the central nervous system is often a life-threatening emergency. In many cases, the clinician faces an unknown pathogen and must rely upon clinical acumen and a thorough, systematic diagnostic investigation to establish a diagnosis and initiate appropriate treatment. Because patients typically present with a syndrome, such as temporal lobe encephalitis, rather than a known pathogen (e.g., herpes simplex virus 1 encephalitis), we describe diagnostic considerations in the context of their neuroanatomic tropisms and patterns of disease. This paradigm refl...
Source: Seminars in Neurology - February 11, 2019 Category: Neurology Authors: Bradshaw, Michael J. Venkatesan, Arun Tags: Review Article Source Type: research

Emergency Management of Epilepsy and Seizures
Semin Neurol 2019; 39: 073-081 DOI: 10.1055/s-0038-1677008Seizure- and epilepsy-related complications are a common cause of emergency medical evaluation, accounting for 5% of 911 calls and 1% of emergency department visits. Emergency physicians and neurologists must be able to recognize and treat seizure- and epilepsy-related emergencies. This review describes the emergency evaluation and management of new onset seizures, breakthrough seizures in patients with known epilepsy, status epilepticus, acute symptomatic seizures, and acute adverse effects of antiepileptic drugs. [...] Thieme Medical Publishers 333 Seventh Avenue,...
Source: Seminars in Neurology - February 11, 2019 Category: Neurology Authors: Bank, Anna M. Bazil, Carl W. Tags: Review Article Source Type: research

Acute Stroke
Semin Neurol 2019; 39: 061-072 DOI: 10.1055/s-0038-1676992Stroke remains one of the leading determinants of death and severe disability worldwide. It is a medical emergency with a narrow window for recognition and administration of outcome-modifying treatment in the emergency department. Ischemic stroke accounts for the majority of cerebrovascular events and revascularization therapies such as intravenous thrombolysis and endovascular thrombectomy are the mainstays of treatment in carefully selected patients. Intracerebral hemorrhage is less common but remains the deadliest type of stroke. Blood pressure reduction and hemo...
Source: Seminars in Neurology - February 11, 2019 Category: Neurology Authors: Morotti, Andrea Poli, Loris Costa, Paolo Tags: Review Article Source Type: research

Acute Visual Disorders —What Should the Neurologist Know?
Semin Neurol 2019; 39: 053-060 DOI: 10.1055/s-0038-1677007Normal vision requires coordination of precisely controlled and coordinated eye movements and normal function of a large cortical and subcortical sensory network. Given the required precision of the system and wide anatomic distribution of the motor and sensory visual systems, vision can be disrupted by a variety of central and peripheral nervous system disorders. While many of these may be relatively benign or have no proven therapy, several may be isolated presentations or harbingers of more serious neurologic conditions. Both monocular and binocular vision losses...
Source: Seminars in Neurology - February 11, 2019 Category: Neurology Authors: Brune, Anthony J. Gold, Daniel R. Tags: Review Article Source Type: research

Evaluation and Management of Neck and Back Pain
Semin Neurol 2019; 39: 041-052 DOI: 10.1055/s-0038-1677044Neck and back pain are common reasons for seeking evaluation and treatment in the emergency department. Within both systems there exist several time-sensitive diagnoses that the emergency provider should be familiar with in order to prevent significant morbidity and mortality. In this article we provide a general overview of these complaints by discussing problems in a systems-based fashion as well as discussing the initial evaluation, work-up, and treatment options for these diagnoses. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Arti...
Source: Seminars in Neurology - February 11, 2019 Category: Neurology Authors: Martel, John W. Potter, Samuel B. Tags: Review Article Source Type: research

Acute Dizziness
Semin Neurol 2019; 39: 027-040 DOI: 10.1055/s-0038-1676857Dizziness is a common chief complaint with an extensive differential diagnosis that includes both benign and serious conditions. Physicians must distinguish the majority of patients who suffer from self-limiting conditions from those with serious illnesses that require acute treatment. The preferred approach to the diagnosis of an acutely dizzy patient emphasizes different aspects of the history to guide a focused physical examination, with the goal of differentiating benign peripheral vestibular conditions from dangerous posterior circulation strokes. Currently, mi...
Source: Seminars in Neurology - February 11, 2019 Category: Neurology Authors: Gurley, Kiersten L. Edlow, Jonathan A. Tags: Review Article Source Type: research

Evaluation and Management of the Emergency Department Headache
Semin Neurol 2019; 39: 020-026 DOI: 10.1055/s-0038-1677023The acute headache in the emergency department (ED) poses a diagnostic dilemma that may overwhelm providers attempting to weigh the cost of advanced workups against the risk of missing serious pathology. While the majority of headache concerns are benign primary headache disorders, identifying life-threatening secondary causes of headache—which may be broadly categorized into structural, infectious, and vascular causes—is the primary focus of evaluation in the ED. Secondary headaches are associated with a high morbidity and mortality, and require strict ...
Source: Seminars in Neurology - February 11, 2019 Category: Neurology Authors: Filler, Levi Akhter, Murtaza Nimlos, Perrin Tags: Review Article Source Type: research