CONTINUUM Lifelong Learning in Neurology最新文献_第4页

Tourette Syndrome and Tic Disorders. 抽动秽语综合征和抽动障碍。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-08-01 DOI: 10.1212/cont.0000000000001595

Jessica Frey

{"title":"Tourette Syndrome and Tic Disorders.","authors":"Jessica Frey","doi":"10.1212/cont.0000000000001595","DOIUrl":"10.1212/cont.0000000000001595","url":null,"abstract":"Objective: This article describes the clinical features of Tourette syndrome and its diagnostic criteria, etiology, and pathophysiology, as well as common myths associated with tic disorders. It discusses the behavioral, pharmacologic, neuromodulation, and alternative treatment approaches to tic disorders.Latest developments: With the significant increase in functional ticlike behavior, especially during the COVID-19 pandemic, diagnostic criteria for functional ticlike behavior have been delineated to separate these ticlike movements from the tics observed in Tourette syndrome. Although behavioral therapy such as comprehensive behavioral intervention for tics remains the first-line treatment for tics, modifications to comprehensive behavioral intervention for tics have been developed to make this type of treatment more accessible. Pharmacologic trials for vesicular monoamine transporter 2 inhibitors have failed to meet the primary endpoint of tic reduction; however, they may still be helpful as add-on therapy for select individuals. A first-in-class compound called ecopipam met the primary endpoint for tic reduction and was well-tolerated, and may be a promising new treatment for Tourette syndrome. Deep brain stimulation may be considered for tics refractory to more conservative approaches.Essential points: Tourette syndrome and tic disorders can substantially affect quality of life. Educating patients about the natural history and expected course of the disease is the most important first step in management. Choosing a treatment based on comorbidities, tic severity, and patient preference is crucial for a beneficial outcome.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 4","pages":"1120-1151"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762316","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

List of Abbreviations. 缩略语列表。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-08-01 DOI: 10.1212/01.cont.0001125776.68533.33

引用次数: 0

Multidisciplinary Treatment for Functional Movement Disorder. 功能性运动障碍的多学科治疗。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-08-01 DOI: 10.1212/cont.0000000000001606

Jon Stone, Alan Carson

引用次数: 0

Issue Overview. 问题概述。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-08-01 DOI: 10.1212/01.cont.0001125884.70303.fb

引用次数: 0

SELF-ASSESSMENT AND CME. 自我评估和继续教育。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-08-01 DOI: 10.1212/cont.0000000000001590

引用次数: 0

Dementia With Lewy Bodies. 路易体痴呆。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-08-01 DOI: 10.1212/cont.0000000000001604

Bhavana R Patel

引用次数: 0

Essential Tremor. 特发性震颤。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-08-01 DOI: 10.1212/cont.0000000000001605

Ludy C Shih

{"title":"Essential Tremor.","authors":"Ludy C Shih","doi":"10.1212/cont.0000000000001605","DOIUrl":"10.1212/cont.0000000000001605","url":null,"abstract":"Objective: Tremor is a common presenting concern and is associated with a wide range of potential etiologies. This article reviews the approach to the clinical evaluation of tremor, the diagnosis of essential tremor, differential diagnoses, and management options.Latest developments: Although new investigational drugs are being studied, no medication besides propranolol has been approved by the US Food and Drug Administration (FDA) as a treatment for essential tremor. Thalamic deep brain stimulation (DBS) has been approved for use since 1997, and refinement of the stimulation target is currently being investigated. Focused ultrasound thalamotomy was approved by the FDA in 2016, and some devices with FDA approval can administer noninvasive transcutaneous afferent patterned stimulation of the median and radial nerves to treat essential tremor. Finally, botulinum toxin injections have shown potential effectiveness for treating head and voice tremors, and methods are currently being refined for potential application in the treatment of upper limb tremors.Essential points: Tremor is a common neurologic symptom and should be distinguished from other movement disorders that may superficially resemble tremor. In addition, essential tremor, a primary tremor disorder consisting of bilateral upper limb action tremor, is commonly misdiagnosed. A careful history and clinical examination for other neurologic findings, such as bradykinesia, dystonia, or evidence of peripheral neuropathy, can reveal potential alternative etiologies of tremor. Drug-induced tremor and metabolic disturbances should always be considered in patients with recent-onset tremor. Oral pharmacotherapies, including propranolol and primidone, are mainstays of treatment, whereas DBS and focused ultrasound thalamotomy can be offered to alleviate disabling, medication-refractory tremor. Novel oral pharmacologic agents, noninvasive stimulation for tremor, and botulinum toxin injections for hand and head tremor need further study but may serve as potential future treatment options.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 4","pages":"979-999"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762303","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

Issue Overview. 问题概述。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/01.cont.0001118476.02055.ce

引用次数: 0

Learning Objectives and Core Competencies. 学习目标和核心竞争力。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/cont.0000000000001582

引用次数: 0

Clinical Features and Diagnosis of Normal Pressure Hydrocephalus. 正常压力性脑积水的临床特点与诊断。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/cont.0000000000001576

Abhay R Moghekar

{"title":"Clinical Features and Diagnosis of Normal Pressure Hydrocephalus.","authors":"Abhay R Moghekar","doi":"10.1212/cont.0000000000001576","DOIUrl":"10.1212/cont.0000000000001576","url":null,"abstract":"Objective: This article serves as a practical guide for the assessment of patients with suspected idiopathic normal pressure hydrocephalus (NPH).Latest developments: Significant advancements in neuroimaging, biomarker identification, and neurosurgical techniques have considerably improved the diagnostic accuracy and outcomes of treatment for idiopathic NPH. The full triad of gait disturbance, cognitive impairment, and urinary incontinence is not present in all patients and is not a prerequisite to pursuing treatment. Comorbid cervical stenosis is common and may also require surgical intervention.Essential points: NPH remains a challenging clinical entity with significant overlap in presentation with other neurodegenerative disorders such as Alzheimer disease, vascular dementia, and parkinsonian syndromes, especially progressive supranuclear palsy and dementia with Lewy bodies. Gait tends to be affected first and more severely than other domains in patients with idiopathic NPH. The CSF tap test is a key diagnostic tool where both objective and subjective improvements in symptoms help identify patients likely to have a good outcome after shunt surgery.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 3","pages":"790-812"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210161","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