CONTINUUM Lifelong Learning in Neurology最新文献_第3页

Optic Neuritis. 视神经炎

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-04-01 DOI: 10.1212/CON.0000000000001560

Eric Eggenberger

{"title":"Optic Neuritis.","authors":"Eric Eggenberger","doi":"10.1212/CON.0000000000001560","DOIUrl":"https://doi.org/10.1212/CON.0000000000001560","url":null,"abstract":"Objective: This article reviews the most common and noteworthy inflammatory and infectious optic neuropathies, with an update on newer syndromes.Latest developments: We have entered an era of antibody-assisted definitions of distinct types of optic neuritis, including aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein-associated disease, with distinct pathophysiologies, prognoses, and management options. It is crucial to distinguish between these entities and other common inflammatory (eg, sarcoid or other granulomatous inflammation) or infectious optic neuropathies as appropriate therapy radically differs. These developments highlight the increasing importance of precision terminology as many of these now distinctly defined syndromes have been previously lumped together as \"typical or atypical optic neuritis.\" An individualized evaluation and treatment approach is required.Essential points: Multiple sclerosis-related optic neuritis is the most common form of inflammatory demyelinating optic neuritis, causing short segments of optic nerve inflammation, with an excellent visual prognosis and tendency to improve with or without high-dose steroids.Aquaporin-4 associated optic neuritis causes longitudinally extensive optic nerve inflammation and has a more guarded prognosis for visual recovery, with poor visual outcomes in untreated patients compared with multiple sclerosis or myelin oligodendrocyte glycoprotein-associated disease.Myelin oligodendrocyte glycoprotein optic neuritis also causes longitudinally extensive optic nerve inflammation with a predilection for optic disc edema and tends to be very steroid sensitive, but recurrent. Infectious optic neuropathies are important to recognize; syphilis incidence has doubled in the last decade and requires early aggressive therapy to maximize visual recovery.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"407-435"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disorders of the Pupil. 瞳孔疾病。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-04-01 DOI: 10.1212/CON.0000000000001542

Aki Kawasaki

引用次数: 0

Epilepsy Comorbidities.

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-02-01 DOI: 10.1212/CON.0000000000001529

Mark R Keezer

{"title":"Epilepsy Comorbidities.","authors":"Mark R Keezer","doi":"10.1212/CON.0000000000001529","DOIUrl":"https://doi.org/10.1212/CON.0000000000001529","url":null,"abstract":"Objective: This article reviews the comorbidities of epilepsy and identifies tools to incorporate comorbidity awareness into clinical practice.Latest developments: The comorbidities of epilepsy are broadly defined, including conditions that may cause but also be a consequence of epilepsy. These can be divided into somatic and psychiatric conditions. Many conditions occur twice as frequently in people with epilepsy compared with the general population. The comorbidities of epilepsy are a major determinant of quality of life and mortality in people with epilepsy. This article provides a concerted focus on the relationship between epilepsy and cognition, mental health disorders, and cardiovascular disease.Essential points: There are practical means of adopting a comorbidity-aware approach to clinical care without overburdening already busy clinical practices. Screening instruments can be used to identify people with comorbid anxiety or depression. Fundamental safety precautions are relevant to all people with epilepsy. Appropriate consideration of the comorbidities of epilepsy, particularly when choosing an antiseizure medication, leads to improved patient care.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 1","pages":"232-246"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Table of Contents.

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-02-01 DOI: 10.1212/CON.0000000000001537

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EEG in Epilepsy.

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-02-01 DOI: 10.1212/CON.0000000000001526

Daniel Weber

{"title":"EEG in Epilepsy.","authors":"Daniel Weber","doi":"10.1212/CON.0000000000001526","DOIUrl":"https://doi.org/10.1212/CON.0000000000001526","url":null,"abstract":"Objective: The purpose of this article is to review the fundamentals and limitations of EEG, guide the selection of EEG type to answer clinical questions, and provide instruction on the interpretation of results within the patient's clinical context.Latest developments: EEG is the single most useful ancillary test to support the clinical diagnosis of epilepsy, but if used incorrectly it can cause great harm. Misapplication of EEG findings can lead to misdiagnosis and long-term mental and physical health sequelae. Although all neurologists may not have sufficient training for independent EEG interpretation, most should be able to review and apply the findings from the report accurately to guide patient care. Longer-term EEGs with similar recording electrodes tend to have higher diagnostic yields. Common EEG findings are described in this article, along with diagnostic limitations of some classically described patterns. There is an updated definition for an epileptiform discharge, along with a consensus on EEG patterns in the critically ill.Essential points: EEG continues to be the most useful ancillary test to assist in the diagnosis of epilepsy. Its application requires proper understanding of its limitations and variability of testing results.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 1","pages":"38-60"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implementing Guidelines and Measures in Epilepsy Care.

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-02-01 DOI: 10.1212/CON.0000000000001540

Christine M Baca

{"title":"Implementing Guidelines and Measures in Epilepsy Care.","authors":"Christine M Baca","doi":"10.1212/CON.0000000000001540","DOIUrl":"https://doi.org/10.1212/CON.0000000000001540","url":null,"abstract":"Abstract: People with epilepsy must receive up-to-date, high-quality care that aligns with current understanding of basic disease mechanisms, improved diagnostic testing, and evolving medical and surgical treatments. Varying progress has been made in identifying, measuring, and mitigating epilepsy care gaps. Epilepsy guidelines and quality measures should be developed using rigorous processes informed by systematic reviews of best evidence in conjunction with prioritization of need. Epilepsy measures help operationalize guidelines and practice parameters. Most epilepsy quality indicators are process-based metrics defined by delivering care to the patient. Systematic and reliable tracking and documentation of seizure frequency using consistent language is required as a patient-reported outcome within individuals over time and across populations. Emerging literature has demonstrated gaps in epilepsy care, perhaps highlighting limitations in the dissemination and implementation of guidelines and quality measures in clinical practice. Quality improvement methods applied to clinical data registries and learning health systems may afford new opportunities to iteratively, collaboratively, and feasibly disseminate guidelines and quality measures, measure epilepsy care quality, allow for the testing of interventions to mitigate identified care gaps, and, ultimately, improve care for patients with epilepsy.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 1","pages":"265-285"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Update on Antiseizure Medications 2025.

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-02-01 DOI: 10.1212/CON.0000000000001521

Bassel W Abou-Khalil

{"title":"Update on Antiseizure Medications 2025.","authors":"Bassel W Abou-Khalil","doi":"10.1212/CON.0000000000001521","DOIUrl":"https://doi.org/10.1212/CON.0000000000001521","url":null,"abstract":"Objective: This article is an update from the article on antiseizure medication therapy published in the three previous Continuum issues on epilepsy and is intended to cover the vast majority of agents currently available to neurologists in the management of patients with epilepsy. This article addresses antiseizure medications individually, focusing on key pharmacokinetic characteristics, indications, and modes of use.Latest developments: Since the most recent version of this article was published, one new antiseizure medication, ganaxolone, has been approved by the US Food and Drug Administration (FDA), and the indications of some approved medications were expanded. Older antiseizure medications are effective but have tolerability and pharmacokinetic disadvantages. Several newer antiseizure medications have undergone comparative trials demonstrating efficacy equal to and tolerability at least equal to or better than older antiseizure medications as first-line therapy for focal epilepsy. These agents include lamotrigine, oxcarbazepine, levetiracetam, topiramate, zonisamide, and lacosamide. Pregabalin was found to be less effective than lamotrigine. Lacosamide, pregabalin, and eslicarbazepine have undergone successful trials of conversion to monotherapy for focal epilepsy. Other newer antiseizure medications with a variety of mechanisms of action are suitable for adjunctive therapy.Essential points: Knowledge of antiseizure medication pharmacokinetics, efficacy, and tolerability profiles facilitates the choice of appropriate antiseizure medication therapy for patients with epilepsy. Rational antiseizure medication combinations should avoid antiseizure medications with unfavorable pharmacokinetic interactions or pharmacodynamic interactions related to mechanism of action.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 1","pages":"125-164"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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CONTRIBUTORS.

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-02-01 DOI: 10.1212/CON.0000000000001554

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List of Abbreviations.

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-02-01 DOI: 10.1212/01.CON.0001098612.74804.b6

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The Harmony of Technology and Expertise.

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-02-01 DOI: 10.1212/CON.0000000000001565

Lyell K Jones

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