US neurology最新文献

Lecanemab: The Price of a Breakthrough Lecanemab:突破的代价

US neurology Pub Date : 2023-01-01 DOI: 10.17925/usn.2023.19.1.14

A. Wimo, L. Jönsson, G. Johansson, B. Winblad

引用次数: 3

Patients’ Beliefs in Optimal Pain Management: A Pilot Study 患者对最佳疼痛管理的信念:一项初步研究

US neurology Pub Date : 2023-01-01 DOI: 10.17925/usn.2023.19.1.41

Alex M. T. Russell, Bridget Marcinkowski, M. Chin

{"title":"Patients’ Beliefs in Optimal Pain Management: A Pilot Study","authors":"Alex M. T. Russell, Bridget Marcinkowski, M. Chin","doi":"10.17925/usn.2023.19.1.41","DOIUrl":"https://doi.org/10.17925/usn.2023.19.1.41","url":null,"abstract":"Opioids are commonly prescribed for chronic pain despite potential adverse side effects, risks of misuse and abuse, and limited evidence for improved outcomes. Patients’ perspectives and understanding of pain management may impact treatment approaches and the success of therapies. Yet, few studies have investigated how patients’ beliefs in optimal pain management may influence their care. We prospectively surveyed 200 patients with chronic pain with the aim of assessing patients’ beliefs on the optimal management of their chronic pain. The following significant findings were made: 1) most responders agreed that opioid medication was the best way to control pain (p<0.05), especially those currently taking opioids (p<0.0001); 2) those who received injections for pain disagreed that opioids were the best way to control pain (p<0.0001); 3) most participants were aware of other options to control pain (p<0.05), but patients on opioids were significantly less aware of other options for pain control (p<0.05). This study demonstrated that most patients with chronic pain surveyed in our clinic believed that opioids were the best option for treating their chronic pain, but this finding did not hold true for those who were exposed to other interventions for their pain, such as injections. Pain physicians may encounter resistance when attempting to incorporate non-opioid and or non-pharmacological therapies for chronic pain management. Further research may help determine whether patient education and exposure to such therapies can help combat these challenges.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67614235","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

The Future of SCN1A Gene-targeting Research for the Treatment of Dravet Syndrome SCN1A基因靶向治疗Dravet综合征研究的未来

US neurology Pub Date : 2023-01-01 DOI: 10.17925/usn.2023.19.2.1

R. Karda

引用次数: 0

A Rare Presentation of Steroid-responsive Encephalopathy Associated with Autoimmune Thyroiditis with Neuropsychiatric Symptoms: A Case Report 罕见的类固醇反应性脑病伴自身免疫性甲状腺炎伴神经精神症状1例报告

US neurology Pub Date : 2023-01-01 DOI: 10.17925/usn.2023.19.2.4

Prashant Bhatele, M. Khanal

{"title":"A Rare Presentation of Steroid-responsive Encephalopathy Associated with Autoimmune Thyroiditis with Neuropsychiatric Symptoms: A Case Report","authors":"Prashant Bhatele, M. Khanal","doi":"10.17925/usn.2023.19.2.4","DOIUrl":"https://doi.org/10.17925/usn.2023.19.2.4","url":null,"abstract":"Background: Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) is an autoimmune disease that appears as a fulminant, subacute or chronic course of altered mental status, often accompanied by seizures and myoclonus. This case report demonstrates that SREAT can be present with solitary neuropsychiatric signs long before seizures and myoclonus. Methods: A 42-year-old female presented with abrupt-onset whole-body myoclonic jerks. She had been suffering from depression for 15 years before being diagnosed with hypothyroidism. She was conscious, oriented and alert. At rest, all four limbs had multifocal mild-to-moderate myoclonus, which was significantly aggravated by muscle activation; her Hamilton Depression Rating Scale score was 21. Results: Antithyroglobulin and antithyroid peroxidase autoantibodies were both above 2,000 IU/mL. The thyroid-stimulating hormone level was 5.65 mIU/mL, free triiodothyronine level was 3.36 pg/mL and free thyroxine level was 1.02 ng/dL. Vasculitis profile and the serum test for autoimmune encephalitis panel were negative. Brain neuroimaging was normal. Pulse dose of methylprednisolone followed by oral steroids resulted in significant clinical improvement. Conclusion: SREAT can present with chronic neuropsychiatric symptoms with abrupt exacerbation of seizures and myoclonus. This case study emphasizes the importance of screening individuals with depression and thyroid problems for serum antithyroid antibody levels. In most cases, steroid treatment yields positive results.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67614421","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: 1

Wellness in Parkinson’s Disease: A Framework for Management Using a Holistic Culturally Sensitive Approach 帕金森病的健康:使用整体文化敏感方法的管理框架

US neurology Pub Date : 2023-01-01 DOI: 10.17925/usn.2023.19.1.8

I. Subramanian, K. Perepezko, B. Stone, R. Chaudhuri, G. Pontone

{"title":"Wellness in Parkinson’s Disease: A Framework for Management Using a Holistic Culturally Sensitive Approach","authors":"I. Subramanian, K. Perepezko, B. Stone, R. Chaudhuri, G. Pontone","doi":"10.17925/usn.2023.19.1.8","DOIUrl":"https://doi.org/10.17925/usn.2023.19.1.8","url":null,"abstract":"The concept of wellness has yet to be formally adopted in Parkinson’s disease (PD) management despite its potential to improve quality of life. Currently, PD treatment is usually focused on symptomatic therapies for motor symptom relief using medications or devices. While the focus on non-motor symptoms has increased in the last decade, it remains suboptimal. Future clinical practice should strive to incorporate the more holistic 'dashboard vitals of PD', which include comorbidities/polypharmacy and dental, vision, bone, and gut health and go beyond just motor and non-motor issues. Furthermore, recognizing and addressing the cultural context of the patient and practising healthcare from a place of cultural humility can help decrease barriers to care and build trust. Promoting self-agency through personalized lifestyle interventions, such as healthy diet, exercise, sleep routines, mind–body approaches and social support, can make them more accessible and easier to maintain. Building upon the concept of personalized medicine in PD, wellness programmes can proactively target non-motor issues and mental and psychosocial health by enhancing resilience and supporting social connections. The desired outcome of a wellness approach extends beyond the traditional medical model to improve quality of life in a more enduring manner.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67614299","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

Omaveloxolone for the Treatment of Friedreich’s Ataxia 奥马维洛龙治疗弗里德赖希共济失调

US neurology Pub Date : 2023-01-01 DOI: 10.17925/usn.2023.19.2.2

Riley Kessler, Sonal Sharma, D. Lynch

引用次数: 0

Paradoxical Tumefactive Worsening of Multiple Sclerosis After Natalizumab Initiation: A Case Report 纳他珠单抗启动后多发性硬化的矛盾性肿瘤恶化:一例报告

US neurology Pub Date : 2023-01-01 DOI: 10.17925/usn.2023.19.2.25

C. Ahern

{"title":"Paradoxical Tumefactive Worsening of Multiple Sclerosis After Natalizumab Initiation: A Case Report","authors":"C. Ahern","doi":"10.17925/usn.2023.19.2.25","DOIUrl":"https://doi.org/10.17925/usn.2023.19.2.25","url":null,"abstract":"Background: Natalizumab is a widely used anti-α4 integrin inhibitor for treating highly active multiple sclerosis. Although clinical and radiological relapses were observed in the pivotal natalizumab trials, severe disease activity after initiation of the drug is a rare phenomenon and has been reported only in isolated cases. Objective: To present a case of a patient who experienced a paradoxical increase in disease activity after the second dose of natalizumab. Methods: We describe the case, review the literature concerning similar cases and suggest possible mechanisms for this phenomenon. Results: Our case involves a patient who developed extensive tumefactive demyelinating lesions and multiple gadolinium-enhancing lesions detected on magnetic resonance imaging after receiving the second dose of natalizumab. A brain biopsy confirmed the presence of demyelination, and the patient’s condition improved after treatment with intravenous methylprednisolone, intravenous immunoglobulin and plasma exchange. Tests for anti-natalizumab antibodies were negative. Conclusions: Paradoxical worsening can occur in the setting of natalizumab treatment, which warrants careful attention and should prompt anti-natalizumab antibody testing. We discuss potential mechanisms. Further research is needed to better understand the mechanisms and risk factors for paradoxical worsening and to develop strategies for mitigating this adverse effect with significant patient impact.","PeriodicalId":90076,"journal":{"name":"US neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67614363","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

Dementia in Europe Yearbook 2022: Employment and Related Social Protection for People with Dementia and Their Carers 《欧洲痴呆症年鉴2022:痴呆症患者及其照护者的就业和相关社会保护

US neurology Pub Date : 2023-01-01 DOI: 10.17925/usn.2023.19.1.2

Owen Miller

引用次数: 0

Sex, Gender and Sexuality in the Context of Dementia: A Guide to Raise Awareness Amongst Health and Social Care Workers 痴呆症背景下的性、社会性别和性行为:提高卫生和社会护理工作者认识的指南

US neurology Pub Date : 2023-01-01 DOI: 10.17925/usn.2023.19.1.4

D. Gove, J. Georges

引用次数: 0

Guidelines for the Ethical and Inclusive Communication About/Portrayal of Dementia and People with Dementia 关于痴呆症和痴呆症患者的道德和包容性沟通/描述指南

US neurology Pub Date : 2023-01-01 DOI: 10.17925/usn.2023.19.1.6

D. Gove, Ana Diaz

引用次数: 1