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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, tempora...
Source: CONTINUUM: Lifelong Learning in Neurology - June 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Obstructive Sleep Apnea
PURPOSE OF REVIEW Obstructive sleep apnea (OSA) is often overlooked by clinicians; however, undiagnosed OSA can lead to negative outcomes for patients, including patients with underlying neurologic conditions. Clinicians should be aware of what questions to ask, what diagnostic tests to use, and what treatments to consider in patients with OSA. RECENT FINDINGS OSA influences many neurologic conditions, including stroke, epilepsy, headache, and neuromuscular conditions. Treatment of OSA is effective, especially with patient-tailored options, the correct education, and support. SUMMARY OSA is a serious medical condit...
Source: CONTINUUM: Lifelong Learning in Neurology - August 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Neurologic Complications in Patients With Cancer
PURPOSE OF REVIEW Neurologic complications in patients with cancer can significantly impact morbidity and mortality. Although these complications can be seen in patients without cancer as well, the purpose of this review is to highlight how the presentation, etiology, and management of delirium, seizures, cerebrovascular disease, and central nervous system infections may be different in patients with cancer. RECENT FINDINGS Some of the newer anticancer therapies are associated with neurologic complications. Delirium and seizures have been described in patients receiving chimeric antigen receptor (CAR) T-cell the...
Source: CONTINUUM: Lifelong Learning in Neurology - December 1, 2020 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

Neurologic Complications of Tuberculosis
This article describes the current epidemiology, common clinical characteristics, and up-to-date evidence-based approaches to the diagnosis and management of the most common neurologic complications of tuberculosis (TB): tuberculous meningitis, intracranial tuberculoma, and spinal TB. RECENT FINDINGS Central nervous system (CNS) TB remains common and associated with significant mortality and neurologic sequelae worldwide. Human immunodeficiency virus (HIV) co-infection is strongly associated with both the development of and mortality due to CNS TB. Strongyloides co-infection is associated with reduced CNS inflammati...
Source: CONTINUUM: Lifelong Learning in Neurology - August 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Neurologic Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection
This article describes the spectrum of neurologic complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, their underlying pathology and pathogenic mechanisms, gaps in knowledge, and current therapeutic strategies. RECENT FINDINGS COVID-19 is the clinical syndrome caused by the novel coronavirus SARS-CoV-2. It can affect the entire neuraxis, and presentations in the acute phase are variable, although anosmia is a common manifestation. Encephalopathy is common in patients who are hospitalized and is often associated with multiorgan involvement. Immune-mediated encephaliti...
Source: CONTINUUM: Lifelong Learning in Neurology - August 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Intracerebral Hemorrhage
This article summarizes the basic pathophysiology, classification, and management of ICH and discusses the available evidence on therapy for hematoma, hematoma expansion, and perihematomal edema. RECENT FINDINGS Current available data on potential therapeutic options for ICH are promising, although none of the trials have shown improvement in mortality rate. The literature available on reversal of anticoagulation and antiplatelet agents after an ICH and resumption of these medications is also increasing. SUMMARY ICH continues to have high morbidity and mortality. Advances in therapeutic options to target seco...
Source: CONTINUUM: Lifelong Learning in Neurology - October 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Acute Neurologic Manifestations of Respiratory Viruses
This article describes the most common respiratory viruses that have neurologic manifestations, with a focus on SARS-CoV-2 and COVID-19. RECENT FINDINGS In vitro and in vivo studies have better elucidated the neurotropism of various respiratory viruses. Understanding host cell receptors that mediate viral binding and entry not only demonstrates how viruses enter host cells but also provides possible mechanisms for therapeutic interventions. Elucidation of SARS-CoV-2 binding and fusion with host cells expressing the angiotensin-converting enzyme 2 (ACE2) receptor may also provide greater insights into its systemic an...
Source: CONTINUUM: Lifelong Learning in Neurology - October 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Language and Aphasias
This article reveals how it is possible for a brain composed of 100 billion highly interconnected, lipid-encased, reticular electrochemical devices to support complex functions such as language and how language disorders can be understood as a reflection of degradation of one or more domains of knowledge. RECENT FINDINGS Ongoing research, building on landmark work regarding parallel distributed processing (PDP), provides the basis for understanding cognitive functions as a manifestation of the activity of populations of millions or billions of neurons in various highly interconnected networks. Population encoding ne...
Source: CONTINUUM: Lifelong Learning in Neurology - December 1, 2021 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

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