510 E Stoner Ave
Shreveport LA 71101
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Traumatic Brain Injury and Behavior: A Practical Approach. - Neurologic clinics
Traumatic brain injury (TBI) is a complex neurologic and neuropathologic process that may affect the patient's behavior permanently. Clinically, TBI is associated with a wide gamut of neurologic and psychiatric disorders, such as amnesia, cognitive decline, seizures, attention and concentration deficits, depression, manic behavior, psychosis, hostile and violent behavior, and personality alterations. Therapy and rehabilitative efforts should be designed based on the type of injury and the patient's specific needs. Gaining familiarity with the behavioral disorders outlined in this article and understanding how to identify and treat them plays a significant role in the management of patients with TBI.Copyright Â© 2016 Elsevier Inc. All rights reserved.
Toxic-metabolic, nutritional, and medicinal-induced disorders of cerebellum. - Neurologic clinics
The human cerebellum is composed of 2 hemispheres and a narrow medial section (vermis). Three pairs of dense fiber bundles (peduncles) connect the cerebellum to the brain. The cerebellum possesses widespread outgoing connections. Insult can result in neurologic deficits, including ataxia, hypotonia, dysarthria, and ocular motility problems. It is particularly susceptible to toxic effects of metabolic and medicinal insults. The cerebellum is potentially sensitive to alcohol, drug exposure, illicit drugs, and environmental poisons (mercury, lead, manganese, and toluene/benzene derivatives). The astute clinician must be aware of the multiple potential factors that can adversely affect cerebellar function.Copyright Â© 2014 Elsevier Inc. All rights reserved.
Multiple sclerosis and pain. - Neurological research
Despite the common belief that multiple sclerosis (MS) is a painless disease, several studies contradict this. There are a significant number of MS patients who actually suffer from painful conditions such as central and peripheral neuropathy, migraines, trigeminal neuralgia, painful tonic spasms, complex regional pain syndrome, glossopharyngeal neuralgia, and transverse myelitis. In addition, MS relapses are usually painful with many patients complaining of paroxysmal dystonia and neuropathic pain during these episodes. Additionally, treatments for MS such as use of beta-interferons may be associated with headache and pain at the injection site. The pathophysiology of pain in MS is poorly understood, but may be related to the development of demyelinating lesions involving certain neuroanatomic pathways such as the spinothalamic tract. Management of pain in MS patients is a therapeutic challenge for clinicians. Currently, various pharmacological agents such as antiepielptics, non-steroidal anti-inflammatory agents, and even corticosteroids are used to suppress various painful conditions associated with MS. Non-pharmacological procedures such as massage therapy have also been used in the treatment of MS patients. The authors present a review of recent findings in pathophysiology and management of pain in MS patients.
Neurologic emergencies: case studies. - Neurologic clinics
During the past 2 decades, the world has witnessed a significant improvement in the understanding of the pathogenesis and treatment of neurologic diseases, which presents emergencies. Every day neurologists are consulted for patients who present with neurologic emergencies to the emergency departments. In this article, we present a series of case reports about patients with acute neurologic and psychiatric problems and discuss their management briefly.Copyright Â© 2012 Elsevier Inc. All rights reserved.
Urgent and emergent psychiatric disorders. - Neurologic clinics
In the emergency department, neurologists regularly evaluate patients exhibiting behavioral abnormalities that stem from underlying neurologic diseases. This behavior may be the initial presence of a neurologic illness or may indicate the deterioration and progress of the disease process. In addition, many neurologic patients present with acute and potentially dangerous psychiatric symptoms that demand rapid and accurate management. Assessment, diagnosis, and treatment of patients with psychiatric manifestations in the context of neurologic illness pose a significant challenge to treating neurologists. This article discusses a general approach to assessment and treatment of some of the more common psychiatric disorders.Copyright Â© 2012 Elsevier Inc. All rights reserved.
Stroke and dementia. - Neurological research
The current review covers causes and risk factors of vascular dementia, including single infarct, multi-infarct and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. Comparisons and distinctions are made between vascular dementia and Alzheimer's dementia, including shared vascular features and risk factors, differential diagnosis based on presenting history, neuropsychological testing results and neuroimaging findings. Neuropsychological findings associated with vascular dementia are discussed, and efforts towards stroke prevention and limiting the recurrence of stroke, as well as emerging treatment possibilities for cognitive decline associated with vascular dementia, are presented.A PubMed-based literature review was performed to acquire recent peer-reviewed publications on vascular dementia.Stroke is one of the leading causes of disability, dementia and death. Within the USA, roughly 660,000 persons will experience a stroke each year. Although many individuals go on to demonstrate substantial improvement and recovery following stroke, a substantial percentage show residual effects including dementia. Vascular dementia has variable causes and manifestations, and research is revealing increasingly more common ground between vascular dementia and Alzheimer's dementia. However, vascular dementia often remains clinically distinct from Alzheimer's dementia, and profiles of neuropsychological impairment can be used to differentiate vascular dementia from the more common Alzheimer's dementia with some success.Vascular dementia causes dependence and disability. Most stroke survivors show improvement, but many develop dementia. Understanding for vascular dementia has recently improved, leading to improved treatment planning. Further research, especially on treatment for vascular dementia, is greatly needed.
Gender issues in multiple sclerosis. - International review of neurobiology
Multiple sclerosis (MS) varies considerably in the way that it affects females and males. The prevalence of the disease is much greater in women and tends to follow a different clinical course than it follows in the affected male population. It is also well known that MS symptoms often are much less of a problem during pregnancy. This chapter discusses possible explanations for gender differences based on sex hormones as well as the effects of these hormones on cytokines and other factors that may influence the course of MS. Knowledge of these effects may hold some promise in other types of treatment for MS. Since MS is much more prevalent in women of child-bearing age, there are also implications for the use of disease-modifying agents as well as drugs and treatments that may be useful for treatment of MS. MS often causes symptoms of sexual dysfunction, but there may be effective treatment for many of these treatments.
Multiple sclerosis and behavior. - International review of neurobiology
Multiple sclerosis (MS) is one of the most frequently seen neurological causes of progressive disability in early to middle adulthood. The disease is variable in its presentation and course, affects roughly 100-300 per 100,000 persons within the United States alone, and is slightly more common among females than males. MS places substantial burdens on patients, families, and caregivers. It negatively affects cognitive abilities and psychiatric functioning, and can add a notably deleterious effect on a patient's quality of life. This chapter reviews the recent literature on the behavioral manifestations of MS. Cognitive domains discussed include executive functioning, processing speed, attention, learning and memory, language functioning, and visual spatial processing. Some attention will also be paid to differential diagnosis and the cognitive effects of treatment. Psychiatric manifestations are also discussed, including symptoms of depression, bipolar disorder, euphoria, pathological laughter and crying, and psychosis, as well as maladaptive personality traits. Finally, the chapter concludes with a discussion of the effects of MS on quality of life including such areas as fatigue, sexual dysfunction, pain, employment, and cognitive functioning.
Neuropsychiatric manifestations of multiple sclerosis. - Neurological research
Multiple sclerosis is one of the most frequently observed neurological causes of progressive disability in early to middle adulthood. The disease is variable in its presentation and course, affects roughly 100 to 300 per 100,000 persons within the US alone and is slightly more common among females than males. Multiple sclerosis places substantial burdens on patients, families and caregivers. Its presentation includes disturbances in cognitive abilities and psychiatric functioning, as well as motor difficulties. This article reviews the current literature on the neuropsychiatric manifestations of multiple sclerosis. Cognitive domains discussed include general cognitive functioning, learning and memory ability, attention, processing speed, executive functioning, visual perceptual ability and language functioning. Attention is also given to alterations in neuropsychiatric functioning associated with disease progression and across various disease subtypes. In addition, reports are also reviewed regarding various psychiatric disturbances, affective changes, quality of life issues and fatigue and pain in individuals with multiple sclerosis. Finally, factors pertaining to pediatric populations in multiple sclerosis are addressed.
Hereditary ataxia and behavior. - Advances in neurology
Recognizing cognitive deficits and psychiatric disorders in patients with autosomal dominant ataxias is relatively new. At this time, the percentage of patients with these disorders who experience changes in cognition or psychiatric symptoms is unknown. Cognitive impairment, when seen, is often found on tests of executive function, probably reflecting disruption of afferent and efferent pathways of the prefrontal cortex and subcortical structures, including the cerebellum. Widespread global dysfunction does occur in some cases, especially later in the disease course. Psychiatric symptoms including depression, aggression, irritability, and psychosis have all been reported. As these behavioral changes receive further study, one hopes that guidelines for treating these symptoms will emerge. Clinicians should be mindful of the psychosocial effects that genetic testing for the hereditary ataxias may have, especially in cases of predictive testing for those who are asymptomatic but at risk because of family history. Guidelines established for genetic testing in HD may be helpful when approaching these cases.
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