{"title":"Table of Contents.","authors":"","doi":"10.1212/CON.0000000000001550","DOIUrl":"https://doi.org/10.1212/CON.0000000000001550","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"316-317"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175825","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}
{"title":"Approach to Vision Loss.","authors":"Nancy J Newman, Valérie Biousse","doi":"10.1212/cont.0000000000001546","DOIUrl":"10.1212/cont.0000000000001546","url":null,"abstract":"<p><strong>Objective: </strong>Diagnosing and differentiating among the many possible localizations and causes of vision loss is an essential skill for neurologists. This article outlines the examination of the eye and visual pathways and the differential diagnosis of pathophysiologic processes that can affect visual function.</p><p><strong>Latest developments: </strong>The eyes, optic nerves, and intracranial pathways of vision account for more than one-third of the volume of the human brain, and patients with vision loss are commonly seen by both eye care specialists and neurologists. A basic examination of the eye and visual pathways allows the neurologist to localize the abnormality causing the vision impairment and generate a differential diagnosis of the potential pathophysiologic processes that can cause a vision problem at that particular location. Neurologists should be aware of the many ocular causes of vision loss and recognize when a visual problem is not the result of an optic neuropathy or brain parenchymal lesion. The standard bedside examination of the visual system can be augmented using specialized ancillary testing of visual pathway structure and function, which is most often the purview of eye care specialists, although portable instruments such as small visual field machines and nonmydriatic ocular fundus imaging can be easily used in hospitals and neurology clinics.</p><p><strong>Essential points: </strong>The approach to vision loss should include a history and examination geared toward localization, followed by a differential diagnosis based on the likely location of the pathophysiologic process. Coordinated care between neurologists and eye care specialists is essential for patients with optic neuropathy or other lesions of the intracranial pathways.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"328-355"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781661","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}
{"title":"Table of Contents.","authors":"","doi":"10.1212/CON.0000000000001550","DOIUrl":"https://doi.org/10.1212/CON.0000000000001550","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"316-317"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781879","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}
{"title":"Approach to Diplopia.","authors":"Devin D Mackay","doi":"10.1212/cont.0000000000001544","DOIUrl":"10.1212/cont.0000000000001544","url":null,"abstract":"<p><strong>Objective: </strong>Diplopia is a frequently encountered neurologic symptom that can lead to apprehension in patients and clinicians. Some causes of double vision are benign, whereas others can be vision-threatening or life-threatening. This article advocates for a systematic approach that includes a targeted history, specific examination techniques, an understanding of basic neuroanatomy, ancillary testing when appropriate, and familiarity with the most important and common causes of double vision and their management.</p><p><strong>Latest developments: </strong>The past prevailing view was that patients older than 50 years with vascular risk factors with a suspected microvascular cranial nerve palsy did not require further evaluation. The frequency of other, sometimes serious, causes of cranial nerve palsies in this patient group justifies the use of neuroimaging, preferably with MRI, for those with an acute palsy of cranial nerve III, IV, or VI, including vascular imaging to exclude aneurysm in patients with a third nerve palsy.</p><p><strong>Essential points: </strong>A systematic, localization-based approach to evaluating patients with diplopia identifies serious causes, avoids wasting health care resources with unnecessary testing, and facilitates timely and appropriate treatment.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"463-478"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781375","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}
{"title":"Optic Neuropathies.","authors":"Lindsey B De Lott","doi":"10.1212/cont.0000000000001545","DOIUrl":"10.1212/cont.0000000000001545","url":null,"abstract":"<p><strong>Objective: </strong>This article highlights the clinical features, evaluation, and management of optic neuropathies commonly encountered in clinical practice.</p><p><strong>Latest developments: </strong>Optic neuropathies encompass all conditions affecting the optic nerve, including those caused by ischemia, inflammation (including infections and autoimmune causes), elevated intracranial pressure, compression and infiltration, toxins, nutritional deficiencies, and hereditary diseases. Surgical and medical treatments targeting the specific causes of optic neuropathies are rapidly expanding, such as surgical options to address papilledema in patients with elevated intracranial pressure and the development of gene therapies for hereditary optic neuropathies. These advances underscore the importance of swift and accurate assessments to identify the cause of optic nerve dysfunction. The evaluation of the patient with an optic neuropathy begins with a careful history and examination. Signs of optic nerve dysfunction include decreased visual acuity, color vision impairment, a relative afferent pupillary defect in the affected eye, and visual field deficits. Neuroimaging of the orbits is one of the most useful tests in determining the cause of an optic neuropathy. Additional diagnostic testing and the formulation of a treatment plan should be guided by the differential diagnosis.</p><p><strong>Essential points: </strong>Optic neuropathies are often misdiagnosed because of errors in eliciting or interpreting the history and physical examination. A systematic approach to identifying the clinical manifestations distinctive to specific optic neuropathies is imperative for directing diagnostic assessments, formulating tailored treatment regimens, and identifying broader central nervous system and systemic disorders.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":"381-406"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781872","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}
{"title":"Key Points for Issue.","authors":"","doi":"10.1212/01.cont.0001110764.63401.62","DOIUrl":"https://doi.org/10.1212/01.cont.0001110764.63401.62","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175819","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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