CONTINUUM Lifelong Learning in Neurology最新文献

{"title":"Sexual and Reproductive Health in the Management of Epilepsy.","authors":"Meriem K Bensalem-Owen","doi":"10.1212/CON.0000000000001531","DOIUrl":"10.1212/CON.0000000000001531","url":null,"abstract":"<p><strong>Objective: </strong>The management of epilepsy should be patient centered, and the treating team should carefully balance eliminating seizures while minimizing adverse effects associated with antiseizure medications. This article highlights important aspects of care related to sexual and reproductive health in people with epilepsy.</p><p><strong>Latest developments: </strong>Gender- and sex-based management in epilepsy can present unique challenges especially in people with epilepsy of childbearing potential. One of the most important considerations with the prescription of antiseizure medications to people of childbearing potential involves reproductive health. Folic acid supplementation is recommended to reduce the risk of congenital malformations, but there is no consensus on the optimal dose. The clinical management of pregnancy in the setting of epilepsy can be challenging. Significant knowledge gaps remain regarding the risks for most new antiseizure medications, neurostimulation therapy, and ketogenic diets during pregnancy. Ongoing multicenter pregnancy registries continue to inform practitioners on the medical treatment of people with epilepsy of childbearing potential. Data evaluating the effect of antiseizure medications on male patients with epilepsy, especially around conception, continue to be insufficient.</p><p><strong>Essential points: </strong>The decision to prescribe an antiseizure medication depends on several considerations because of the potential for lifetime treatment with a daily medication. It is important to tailor management to the patient's specific circumstances. Seizures and antiseizure medications can both affect sexual and reproductive health. Furthermore, hormone fluctuations may affect seizure frequency, treatment, and contraception. All these factors should be considered when treating people with epilepsy during their reproductive years. In addition, it is important to foster a multidisciplinary approach for the treatment of people with epilepsy.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 1","pages":"214-231"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082170","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":"SELF-ASSESSMENT AND CME.","authors":"","doi":"10.1212/CON.0000000000001523","DOIUrl":"10.1212/CON.0000000000001523","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 1","pages":"287"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082167","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":"SELF-ASSESSMENT AND CME.","authors":"","doi":"10.1212/CON.0000000000001523","DOIUrl":"https://doi.org/10.1212/CON.0000000000001523","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 1","pages":"287"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175815","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":"Surgical Treatments, Devices, and Nonmedical Management of Epilepsy.","authors":"Daniel Friedman","doi":"10.1212/CON.0000000000001528","DOIUrl":"10.1212/CON.0000000000001528","url":null,"abstract":"<p><strong>Objective: </strong>Many patients with epilepsy are unable to achieve optimal seizure control with medical therapy. This article focuses on surgical approaches, dietary therapies, and seizure detection devices.</p><p><strong>Latest developments: </strong>For more than a century, resective epilepsy surgery has been a treatment option for some patients with drug-resistant epilepsy. Other surgical options have emerged for patients for whom resection is not possible or is associated with unacceptable risks, including minimally invasive epilepsy surgery and neurostimulation therapies. Dietary therapies, such as the ketogenic diet, can also help improve seizure control, especially in children. For patients with ongoing nocturnal convulsive seizures, seizure detection devices can alert caregivers and potentially reduce the risk of sudden unexpected death in epilepsy (SUDEP).</p><p><strong>Essential points: </strong>Patients with drug-resistant epilepsy should be referred to comprehensive epilepsy centers to determine if they qualify for nonpharmacologic treatment options to reduce the risk of seizures and premature death and improve quality of life.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 1","pages":"165-186"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082174","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":"Issue Overview.","authors":"","doi":"10.1212/01.CON.0001098616.12668.ec","DOIUrl":"10.1212/01.CON.0001098616.12668.ec","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082147","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.CON.0001098196.53607.f4","DOIUrl":"10.1212/01.CON.0001098196.53607.f4","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082149","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":"Diversity and Underserved Patient Populations in Epilepsy.","authors":"Dave F Clarke","doi":"10.1212/CON.0000000000001533","DOIUrl":"10.1212/CON.0000000000001533","url":null,"abstract":"<p><strong>Objective: </strong>Despite advancements in epilepsy management, disparities and lack of inclusion of many people with epilepsy are associated with increased morbidity and mortality. Compounding these problems is the paucity of diversity among health care providers, research participants, and researchers. This issue as well as potential solutions are explored in this article.</p><p><strong>Latest developments: </strong>Prompted by recent social justice incidents, patient advocacy groups, epilepsy societies, and governing bodies such as the National Institute of Neurological Disorders and Stroke, US Centers for Disease Control and Prevention, and the Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders have proposed initiatives to improve disparities in epilepsy care. Public health epilepsy research continues to expose deficiencies and disparities. Increased awareness of health care gaps and technologic advances should help foster improved epilepsy health equity and inclusivity.</p><p><strong>Essential points: </strong>To deliver timely, effective care for people with epilepsy, we must be knowledgeable of sociodemographic obstacles to access. These include confounding factors such as historical determinants, unconscious bias, and lack of diversity. Improving awareness and promoting diversity in research participation can advance treatment for underserved populations and improve trust.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 1","pages":"247-264"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082110","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.CON.0001095000.40753.3f","DOIUrl":"10.1212/01.CON.0001095000.40753.3f","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"30 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774687","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":"Learning Objectives and Core Competencies.","authors":"","doi":"10.1212/CON.0000000000001512","DOIUrl":"10.1212/CON.0000000000001512","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"30 6","pages":"1574"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774692","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":"LATE, Hippocampal Sclerosis, and Primary Age-related Tauopathy.","authors":"Vijay K Ramanan, Jonathan Graff-Radford","doi":"10.1212/CON.0000000000001499","DOIUrl":"https://doi.org/10.1212/CON.0000000000001499","url":null,"abstract":"<p><strong>Objective: </strong>Although Alzheimer disease (AD) is the most common neurodegenerative cause of dementia, neurologists must be aware of other etiologies that can mimic the amnestic-predominant syndrome and medial temporal brain involvement typically associated with AD. This article reviews recent updates surrounding limbic-predominant age-related transactive response DNA-binding protein 43 (TDP-43) encephalopathy (LATE), hippocampal sclerosis, and primary age-related tauopathy.</p><p><strong>Latest developments: </strong>LATE neuropathologic change occurs in approximately 40% of autopsied older adults, including occurrences in isolation in some older individuals with amnestic cognitive impairment. LATE neuropathologic change is often, but not always, associated with hippocampal sclerosis (neuronal loss and gliosis in the hippocampus and associated structures) and frequently coexists with AD and other neurodegenerative pathologies. Although there is no direct clinical biomarker for TDP-43 pathology, recent studies suggest that a clinical diagnosis of LATE can be achieved through the integration of multiple data points. Primary age-related tauopathy refers to the pathologic finding (in some cognitively unimpaired older adults as well as some individuals with cognitive impairment) of medial temporal-predominant neurofibrillary tangles in the absence of amyloid-β (Aβ) plaques. Recent consensus frameworks have attempted to resolve ambiguities of nomenclature and diagnosis for these entities, and efforts toward in vivo biomarkers are ongoing.</p><p><strong>Essential points: </strong>LATE, with or without hippocampal sclerosis, and primary age-related tauopathy belong in the differential diagnosis (along with AD, argyrophilic grain disease, and other disorders) for slowly progressive amnestic-predominant cognitive impairment, particularly in individuals older than 75 years. Accurate recognition of clinical and diagnostic test features supportive of these non-AD entities is vital to optimize patient counseling, therapeutic selection, and novel biomarker development.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"30 6","pages":"1726-1743"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774690","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}