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At least 145 records · Page 8Linked to original sources
PubMed2003

Fetal and neonatal neurologic case histories: assessment of brain disorders in the context of fetal-maternal-placental disease. Part 1: Fetal neurologic consultations in the context of antepartum events and prenatal brain development.

The pediatric neurologist can contribute to a fetal diagnostic service that includes the maternal-fetal specialist as well as placental and pediatric pathologists, neonatologists, neurosurgeons, geneticists, and other pediatric subspecialists. Selected case histories of patients who presented to our fetal neurology service illustrate the wide spectrum of disease entities that are highly dependent on the time during gestation, location of brain injury, and the direct as well as indirect effects of fetal/maternal/placental disease processes on brain maturation. The pediatric neurologist has the opportunity to provide an important consultative role, bridging prenatal to neonatal life and integrating medical and ethical concerns for the child in the context of the family.

Adolescent↗
PubMed2001

A profile of neurology practice based on Medicare services: an AAN Medical Economics and Management Committee report. American Academy of Neurology.

OBJECTIVE: This report uses Medicare data to provide insight into the patient care services most often provided by neurologists. METHODS: The 1998 Medicare data set for physician services was obtained from the Health Care Financing Administration. Neurologists' services were tabulated and compared to the 1998 American Academy of Neurology Member Demographic and Practice Characteristics Report. A profile was derived of neurologists' typical services. RESULTS: Patient visits represent 70% of neurologists' services when evaluated by income. Office was the site of service for 62% of patient visit income. Established patients were 29% of patient visit income. Neurologists frequently code patient visits at levels of service higher than used by other physicians. EMG and nerve conduction velocity together represent 55% of neurodiagnostic services when evaluated by income. CONCLUSIONS: Patient care continues to be the main service of neurologists, with office care more than hospital care. Established patient care is an important part of patient services, confirming the role of the neurologist in principal care. Neurologists' patient care levels of service are higher than for other physicians.

Medicare↗
PubMed2002

Practice parameter: neuroimaging of the neonate: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society.

OBJECTIVE: The authors reviewed available evidence on neonatal neuroimaging strategies for evaluating both very low birth weight preterm infants and encephalopathic term neonates. IMAGING FOR THE PRETERM NEONATE: Routine screening cranial ultrasonography (US) should be performed on all infants of <30 weeks' gestation once between 7 and 14 days of age and should be optimally repeated between 36 and 40 weeks' postmenstrual age. This strategy detects lesions such as intraventricular hemorrhage, which influences clinical care, and those such as periventricular leukomalacia and low-pressure ventriculomegaly, which provide information about long-term neurodevelopmental outcome. There is insufficient evidence for routine MRI of all very low birth weight preterm infants with abnormal results of cranial US. IMAGING FOR THE TERM INFANT: Noncontrast CT should be performed to detect hemorrhagic lesions in the encephalopathic term infant with a history of birth trauma, low hematocrit, or coagulopathy. If CT findings are inconclusive, MRI should be performed between days 2 and 8 to assess the location and extent of injury. The pattern of injury identified with conventional MRI may provide diagnostic and prognostic information for term infants with evidence of encephalopathy. In particular, basal ganglia and thalamic lesions detected by conventional MRI are associated with poor neurodevelopmental outcome. Diffusion-weighted imaging may allow earlier detection of these cerebral injuries. RECOMMENDATIONS: US plays an established role in the management of preterm neonates of <30 weeks' gestation. US also provides valuable prognostic information when the infant reaches 40 weeks' postmenstrual age. For encephalopathic term infants, early CT should be used to exclude hemorrhage; MRI should be performed later in the first postnatal week to establish the pattern of injury and predict neurologic outcome.

Academies and Institutes↗
PubMedDate not supplied

[Neurological assistance as a product. Evaluation of the process in neurology].

INTRODUCTION: Appraisal of the process of assistance is a fundamental step in determination of the quality of medical assistance given. DEVELOPMENT AND CONCLUSIONS: In this paper we review the concept of medical assistance as a product, establishing a parallel between medical assistance and a process of industrial production. We consider the similarities and differences between them. From the point of view of production management we may distinguish different elements: the setting, structure, process of production, result and evaluation. All these are also found in healthcare assistance. We review the concept of the process of assistance both from the limited point of view of the management of disease and its complications, and from a broader perspective which includes the activities of patients in seeking and obtaining assistance. Different aspects and methods of appraisal of the process of assistance are considered: medical audit and monitoring. Finally, we approach the problem of appraisal of the process in outpatient assistance, the importance of this and the methods used in evaluation. We comment on experience of this aspect obtained in the Neurology Unit of the Hospital Marina Alta in Denia.

Evaluation Studies as Topic↗
PubMed2002

[Lluís Barraquer Roviralta (1855-1928), founder of Spanish clinical neurology. The origin of the first school of neurology in Spain].

Lluis Barraquer Roviralta (1855-1928) was the founder, when he was 27 years old, of the first nucleus of clinical Neurology and electro therapy in Spain, in 1882. This nucleus was located in the Hospital de la Sta. Creu i Sant Pau (of the Holy Cross and Sant Paul), dated from 1401. His work was marked and founded upon a great and deep knowledge of the anatomy of the central and peripheral nervous system, and of the fine semiology approach of its pathological derangement, and also of the electrodiagnostic techniques. In this way he could make several princeps descriptions: of the generalisated muscular dystonia (1897), of the cephalothoraric lypodystrophy (1906), of the grasp reflex of the foot (1921) and of the diffused hemilateral atrophy of dystrophic-sympathetic pathogenesis (1925). He makes also a very minocious analysis of the idiomuscular reaction. He promoted the firts steps of neurosurgery in Barcelona. Another aspect of its activity was the study of the degeneration and regeneration of the peripheral nervous system in rabbits. He described the neural semiology of the lepra. He performed personaly a great activity in collecting images of the semiology of nervous disease and of macroscopic pathological anatomy, leaving about 2,000 images.

History, 19th Century↗
PubMed1998

[The Internet application to neurology: electronic forums of Revista de Neurología. How The Internet, Medicine and Neurology Forum has been developed].

The new communication techniques and, particularly, Internet, are changing our way of collaborating, relating to each other and searching for information, paving the way for telemedicine. Such initiatives are described in the Revista de Neurologia, as well as the methodology followed to prepare the first Electronic Forum of the Revista de Neurologia on 'Internet, Medicine and Neurology', using the web, IRC and E-mail tools.

Humans↗
PubMed2002

Standards of neurologic-neurosurgical early rehabilitation--a concept of the study group neurological-neurosurgical early rehabilitation.

Neurological neurosurgical early rehabilitation (NNER) is a new important therapeutic link within the spectrum of neurorehabilitation. This concept was formulated by expert opinion of the German Task Force on NNER to define both the structural and process quality of rehabilitation in patients who sustained brain damage with sensory motor, cognitive, and neurobehavioural impairment. NNER is focused on improving higher nervous functions, preventing or treating secondary and tertiary complications and thus to recuse disabilities. This concept is based on interdisciplinary teamwork and needs multidisciplinary cooperation with all specialists involved. The progress of recovery can be measured with the aid of the Coma Remission Scale.

Caregivers↗
PubMed1984

Neurological diseases as seen at the outpatient Paediatric Neurology Clinic in Benin City.

There is a paucity of literature about the pattern of neurological diseases in children attending out-patient departments in Africa. In this study more boys than girls presented at our clinic. Almost all the principal diseases seen are eminently preventable. There appears to be no effective immunization programme. There is need for epidemiological studies to ascertain the true incidence of subacute sclerosing panencephalitis in view of the high incidence of measles in the community.

Adolescent↗
PubMed2000

Practice parameter: evaluating a first nonfebrile seizure in children: report of the quality standards subcommittee of the American Academy of Neurology, The Child Neurology Society, and The American Epilepsy Society.

OBJECTIVE: The Quality Standards Subcommittee of the American Academy of Neurology develops practice parameters as strategies for patient management based on analysis of evidence. For this practice parameter, the authors reviewed available evidence on evaluation of the first nonfebrile seizure in children in order to make practice recommendations based on this available evidence. METHODS: Multiple searches revealed relevant literature and each article was reviewed, abstracted, and classified. Recommendations were based on a three-tiered scheme of classification of the evidence. RESULTS: Routine EEG as part of the diagnostic evaluation was recommended; other studies such as laboratory evaluations and neuroimaging studies were recommended as based on specific clinical circumstances. CONCLUSIONS: Further studies are needed using large, well-characterized samples and standardized data collection instruments. Collection of data regarding appropriate timing of evaluations would be important.

Adolescent↗
PubMed2004

Percutaneous endoscopic gastrostomy: a safe and effective bridge for enteral nutrition in neurological or non-neurological conditions.

Percutaneous endoscopic gastrostomy (PEG) is one of the most commonly used methods for nutritional support in patients who are unable to take food orally. Traditional surgical gastrostomy, percutaneous radiologic gastrostomy, and laparoscopic gastrostomy are the alternatives. The most common indication is neurogenic dysphagia followed by obstructive causes such as head and neck tumors. Ethically justified and clinically comprehensive guidelines should be followed during the decision-making process for PEG tube placement. A limited life expectancy; technical difficulties, such as the inability to bring the anterior gastric wall in apposition to the abdominal wall; or pharyngeal/esophageal obstruction, which compromise tube insertion, peritonitis, and uncorrectable coagulopathy are absolute contraindications. The "pull method" is the first described and still the most performed technique of PEG tube placement. The procedure is simple, safe, and effective and fulfills all requirements to provide an ideal route for nutritional support. This article summarizes the reported experience on PEG in the current literature and discusses its utility in patients with neurological conditions.

Deglutition Disorders↗
PubMed2001

Nerve growth factor in neurological and non-neurological diseases: basic findings and emerging pharmacological prospectives.

Nerve growth factor (NGF) is known to be essential for the survival of peripheral and brain neurons, and according to more recent studies also for a variety of cells localized in the immune system. Basic and preclinical findings published in the last 15-20 years have prospected the hypothesis that NGF can be pharmaceutically useful for promoting healing in certain peripheral and central neurological insults. We have recently provided evidence that NGF applied topically, has a therapeutic potentiality for human corneal and pressure ulcers, and more recently in vasculitis induced by rheumatoid arthritis. This review will summarize previous and ongoing evidence supporting the role of NGF in the nervous and immune system and discuss NGF potentiality as a pharmacological tool for basic and clinical studies.

Animals↗
PubMed1999

[Chronic recurrent headache without neurological abnormalities. Practice guidelines of the Netherlands Society of Neurology].

The diagnosis of chronic recurrent headache without neurological abnormalities is based on the anamnesis and physical examination; EEG or other supplementary examinations as a rule are not indicated. Regarding treatment of migraine, a distinction is made between attack treatment, preferably with non-specific drugs (analgetics and non-steroid anti-inflammatory agents (NSAIDs)) after aural symptoms if any, and prophylactic treatment (agents of choice: beta-receptor blockers). Cluster headache requires adequate treatment as soon as possible after the diagnosis, usually with attack treatment (sumatriptan s.c. or oxygen) as well as prophylactic treatment (agent of choice: verapamil). In the treatment of tension headache, a non-pharmaceutical treatment (relaxation) is to be preferred to pharmacotherapy (tricyclic antidepressants). Patients with chronic recurrent headache should be asked about excessive use of analgetics and caffeine-containing beverages, because these (or abstinence from them) may be the cause of the symptoms.

Chronic Disease↗
PubMedDate not supplied

Caspase-1 levels in biological fluids from patients with multiple sclerosis and from patients with other neurological and non-neurological diseases.

In multiple sclerosis (MS), pathological white matter damage in the central nervous system is sustained by immune-inflammatory response. Caspase-1 plays a pivotal role in immune-mediated inflammation, as it regulates the cellular export of IL-1beta and IL-18. We carried out a preliminary in vitro study of the kinetics of extracellular caspase-1 release. We then measured caspase-1 levels in paired serum and cerebrospinal fluid (CSF) samples of 75 MS patients, 15 healthy subjects, and patients with other neurological diseases. Paired synovial fluid and serum samples of patients with juvenile idiopathic arthritis, and paired sputum and serum samples of asthma patients were also studied. Mean serum caspase-1 concentrations did not differ between groups. Caspase-1 was detected in the CSF of patients with acute, but not stable, MS [7.5 +/- (SEM) 0.9 pg/ml; test's sensitivity, 56% and specificity, 100%]. Its levels correlated with pleocytosis. The highest mean caspase-1 levels were found in the arthritic synovial fluids (945.5 +/- 126.6 pg/ml, which correlated with erythrocyte sedimentation rate), and in the sputum samples (370.1 +/- 71.0 pg/ml, which correlated with the number of macrophages in the sputum). On condition that caspase-1 is determined in the fluids pertaining to the disease-specific inflammatory sites, its level is a reliable marker of ongoing immune-inflammatory response. The enzyme measurement in CSF can also help define state-trait in MS.

Arthritis, Juvenile↗
PubMed1976

[Neurological manifestations in monoclonal gammapathies. Pure neurological manifestations. Immunofluorescence study].

Analysis of 105 peripheral and central nervous system complications in 1062 monoclonal gammapathies draws attention to two types of phenomena. The possibility of pure neurological manifestations of IgM monoclonal gammapathies with macroglobulinorachia leads to discussion of their nosological position in relation to Waldenström's disease, Burkitt's lymphoma and Marek's disease. It is suggested that these cases should be reclassified under the heading "secreting neurolymphomatosis". Immunofluorescence and electron microscopy of 10 biopsies of the peripheral nerve showed deposits of monoclonal immunoglobulin whose function in determining peripheral neuropathies is discussed. The simultaneous presence of lymphoid infiltration, amyloid deposits and the monoclonal immunoglobulin (M component) suggests that this immunoglobulin could be the link between the cellular infiltrate secreting it and amyloid infiltration which would be the visible manifestation of it.

Amyotrophic Lateral Sclerosis↗
PubMedDate not supplied

[Coping with illness in the early phase of severe neurologic diseases. A contribution of music therapy to psychological management in selected neurologic disease pictures].

In many cases neurological diseases become traumatic because of their abrupt appearance resulting in physical and/or mental impairment, which is often experienced as deep narcicistic offence. Assumpting that there exist a correlation between successful functional rehabilitation and emotional coping strategies and because the factor "time" is as well relevant for the full development of potential early support in the sense of guiding through morning and grief to be necessary. By two case studies, one in the field of physical handicap and one in the field of severe head injury by road accident, it is tried to point out the special possibilities of music therapy including the question of induction.

Adaptation, Psychological↗