CONTINUUM Lifelong Learning in Neurology最新文献_第6页

Nystagmus and Saccadic Intrusions. 眼球震颤和眼球内斜视

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-04-01 DOI: 10.1212/CON.0000000000001561

Daniel Gold

{"title":"Nystagmus and Saccadic Intrusions.","authors":"Daniel Gold","doi":"10.1212/CON.0000000000001561","DOIUrl":"10.1212/CON.0000000000001561","url":null,"abstract":"Objective: This article describes the diagnosis and differentiation of the many possible localizations and causes of nystagmus.Latest developments: The eyes move to keep the fovea on the object of visual regard. To account for the movement of targets, the environment, or the self, different classes of eye movement are necessary to achieve visual stability. These movements involve the vergence, smooth pursuit, saccadic, vestibular, and optokinetic systems, as well as the ability to suppress the vestibuloocular reflex and other movements for steady fixation. When the equipoise of one or more of these systems is disrupted, nystagmus or saccadic intrusions may result. The astute clinician can distinguish between benign (eg, infantile or peripheral vestibular nystagmus) and dangerous (eg, stroke, Wernicke encephalopathy) etiologies with a high degree of confidence at the bedside, making expensive eye movement recording equipment unnecessary in the majority of cases.Essential points: The recognition and interpretation of nystagmus and saccadic intrusions in the context of the history and a comprehensive ocular motor and neurologic examination is an essential skill in neurologic practice.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"503-526"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781824","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

Epilepsy Comorbidities. 癫痫并发症。

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":"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}

引用次数: 0

Table of Contents. 目录表。

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

引用次数: 0

List of Abbreviations. 缩略语列表。

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

引用次数: 0

EEG in Epilepsy. 癫痫的脑电图。

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":"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. 癫痫护理实施指南和措施。

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":"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. 抗癫痫药物更新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":"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}

引用次数: 0

CONTRIBUTORS. 贡献者。

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

引用次数: 0

List of Abbreviations. 缩略语列表。

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

引用次数: 0

The Harmony of Technology and Expertise. 技术与专业知识的和谐。

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

Lyell K Jones

引用次数: 0