New CME Series

Restless Legs Syndrome: Recognition, Diagnosis, and Treatment of a Common Sleep Disorder

  • Screening for Sleep Disorders: Recognizing the Features and Presentations of Restless Legs Syndrome
  • Common Comorbidities and Differential Diagnosis of Restless Legs Syndrome
  • Latest Guidelines and Advances for Treatment of Restless Legs Syndrome

Alzheimer’s Disease: The Importance of Early Diagnosis and Appropriate Management

  • Early Diagnosis and Management of Alzheimer’s Disease
  • Alzheimer’s Disease: The Importance of Early Diagnosis and Appropriate Management
  • Clinician’s Toolbox for Alzheimer’s Disease

See all Neurology Reports

 
FEATURED ARTICLES

Which forms of rapidly progressive dementia are treatable and reversible, and which aren't? Use this case vignette to explore the appropriate workup, differential diagnosis, and care for a rapidly progressive dementia in a 57-year-old man.

Delirium is associated with long-term neuropsychiatric consequences and increased mortality, yet it is underdiagnosed and a minimal focus of formal medical education. Review results from the first study to examine the educational impact of a psychiatric liason on beliefs and knowledge about delirium among both nurses and residents.

Are you aware of the safety and risk management obligations of using opioids in treating chronic pain? In this Neurology Report, review the use of opioids in pain treatment and learn about tools and methods that can help you to assess patients for abuse risk and safeguard them during treatment.

See all Alzheimer's Disease

ALZHEIMER'S DISEASE

Previous surveys have sought to capture the impact of Alzheimer’s disease from the caregiver’s perspective. The surveys described in this article were designed to investigate experiences and perceptions of caregivers of patients with Alzheimer’s disease who were receiving rivastigmine transdermal patch therapy.

In this review article, Nordberg and colleagues examine the role of butyrylcholinesterase (BuChE) in cholinergic signaling and neurologic conditions, such as Alzheimer’s disease. The rationale for inhibiting cholinesterases in the management of Alzheimer’s disease is discussed.

The use of biomarkers in early Alzheimer’s disease detection is growing. However, it is not clear whether sophisticated biomarker testing is more efficient than neuropsychological tests focused on memory. The goal of this study was to evaluate the predictive value of the Memory Impairment Screen (MIS), a simple and brief memory test, in elderly subjects with subjective memory loss.

See all Autism

AUTISM

Autistic disorder is characterized by qualitative impairments in reciprocal social interaction, verbal and nonverbal communication, among other characteristics.

Autism is a neurodevelopmental disorder with childhood onset characterized by atypical developments.

See all Dementia

DEMENTIA

When Mr A, a 68-year-old man, presents to Banner Alzheimer’s Institute, his wife says his short-term memory has been declining for 3 years. Mr A is irritable and states that the things he forgets are things that he does not want to remember. In private, his wife also reports “tactless” behaviors and loss of empathy toward others. What is causing his symptoms?

Which forms of rapidly progressive dementia are treatable and reversible, and which aren't? Use this case vignette to explore the appropriate workup, differential diagnosis, and care for a rapidly progressive dementia in a 57-year-old man.

Did you know that dementia with Lewy bodies accounts for up to 35% of dementia cases? Get a summary of the diagnostic criteria and clinical features of dementia with Lewy bodies, find out about its pathology and radiographic features, and get recommendations for treating this disorder in primary care.

See all Headache

HEADACHE

A vast array of idiopathic somatic complaints are common among depressed persons across the lifespan.

Headaches account for a high percentage of office visits to primary care physicians.

See all Movement Disorders

MOVEMENT DISORDERS

Parkinsonism is a neurologic syndrome that manifests as any combination of 6 cardinal features: tremor at rest, rigidity, bradykinesia/hypokinesia, flexed posture, loss of postural reflexes, and the freezing phenomenon.

Tardive dyskinesia is a well-known side effect of conventional antipsychotics. Fluvoxamine may be an effective treatment for neuropsychiatric disorders via sigma-1 receptor agonism. Here, Albayrak and colleagues report 5 cases in which fluvoxamine was beneficial for both postpsychotic depressive disorder and tardive dyskinesia in patients with schizophrenia.

Are neuromotor abnormalities a feature of psychotic illness or the result of side effects of antipsychotic medication? To answer this question, this study examined the effect of antipsychotic medication on neuromotor abnormalities in psychotic patients who had not been exposed to antipsychotic drugs.

See all Multiple Sclerosis

MULTIPLE SCLEROSIS

Early treatment can slow the progression of multiple sclerosis. Read this activity to learn about first- and second-line agents to treat MS, and find out about medication to help alleviate accompanying symptoms.

Are you familiar with the most common pain syndromes associated with MS? In this Neurology Report, review central neuropathic and nociceptive pain symptoms frequently experienced by patients with MS, and learn which evidence-based treatments are appropriate for each type of pain.

Have you ever wondered how often multiple sclerosis (MS) is complicated by neuropsychiatric symptoms such as depression, mania, or cognitive impairment?

See all Other

OTHER

Read about the case of Mr A, a 29-year-old man who experienced symptoms of panic, agitation, paranoia, and delirium after using K2, an herbal marijuana alternative.

People make cognitive errors all of the time. This skewed thinking is one way that the medically ill may add emotional distress to their physical problems. Read about the case of Mr A, a retired internist who focused more and more on his own explanations for his physical symptoms. He became angry, sad, and worried most of the time. A brief psychotherapeutic intervention was implemented to quiet Mr A’s active mind.

Comorbid mood and substance disorders are often a hurdle to effective treatment, and add-on strategies are usually adopted to overcome treatment resistance. The authors of this article investigated the possible anticraving efficacy of high-frequency deep transcranial magnetic stimulation of the bilateral dorsolateral prefrontal cortex in 3 patients with comorbid long-term DSM-IV-TR dysthymic disorder and alcohol use disorder.

See all Pain

PAIN

Is there a relationship between trauma in childhood and pain in adulthood? To answer this question, the authors of this study examined 5 types of trauma (witnessing violence, physical neglect, emotional abuse, physical abuse, and sexual abuse) in a primary care outpatient sample and their relationship to pain and pain catastrophizing.

Find out if the drug milnacipran was effective in a small group of patients who continued to experience knee pain for a year or more despite having an otherwise successful knee replacement. In this 12-week open-label study, patients were given milnacipran at doses of 100 to 200 milligrams a day while investigators from Duke University assessed their knee pain and function with a variety of measures.

Patients with medical conditions, such as pain, inflammation, and diabetes, are at an increased risk for developing depression, and vice versa. View this virtual slide show to learn about the co-occurrence of these conditions and what that means for the treatment of your patients with depression, pain, and comorbid medical conditions.

See all Parkinson's Disease

PARKINSON'S DISEASE

The role played by the brain’s dopamine system in pain control has garnered attention in recent years.

In this era of exponential growth of the "metabolic syndrome" and obesity, lifestyle modifications could be a cost-effective way to improve health and quality of life.

We describe a patient in a skilled nursing facility who had symptom exacerbation of bipolar disorder while taking divalproex and olanzapine.

See all Sleep

SLEEP

International epidemiology studies have shown that the rate of sleep quality disorder is 15% to 35% in adults. However, the effects of mental disorders on the sleeping period and rhythm have been less reported. In this study, the authors investigated the sleep characteristics of a community sample of patients with 13 common types of mental disorders in Hebei Province, Baoding, China.

Read this series of Brief Reports to learn about the pathophysiology, prevalence, and consequences of shift work disorder and to discover how to diagnose this problem when you encounter it in clinical practice.

Little research exists to examine the combined roles of major depressive disorder (MDD) and insomnia in health care expenditures and impaired work function. This study by Kim and colleagues evaluated health care utilization, costs, and work productivity loss associated with insomnia in patients newly diagnosed with MDD.

See all Stroke

STROKE

Have you ever wondered how people cope with the devastating sequelae of strokes?

We read with interest the recenetly published discussion concerning the use of atypical antipsychotic medications in the primary care setting.

Is it reasonable to assume that just about everyone becomes depressed following a stroke?

SUBSTANCE ABUSE/ALCOHOLISM

See all Substance Abuse/Alcoholism

Have you ever considered whether certain medications or foods can contribute to false-positive or false-negative drug screens? If you have, then the following case vignette and discussion should serve as a stimulus for further inquiry into these and other questions.

Have you ever wondered what prompts a patient to become suddenly and severely agitated, with prominent elevations in temperature, heart rate, and blood pressure? Have you been challenged by how to initiate safe and effective treatment in patients who have similar signs and symptoms? If you have, then this case vignette and discussion should serve as a stimulus for further inquiry into these and other questions.

The authors of this article investigated the possible anticraving efficacy of high-frequency deep transcranial magnetic stimulation of the bilateral dorsolateral prefrontal cortex in 3 patients with comorbid long-term DSM-IV-TR dysthymic disorder and alcohol use disorder.