The Journal of neuropsychiatry and clinical neurosciences
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The authors present a cross-sectional survey designed to evaluate the presence of delirium in patients with neurological emergencies. Two hundred and two patients were included in the study: 14.9% of subjects had delirium; 62.4% had no arousal disturbances; and 22.7% presented a coma or stupor state. Findings revealed that the presence of a cerebral infection, the presence of multiple etiologies, and the location of lesions in the frontal and temporal lobes were all associated with delirium. Results substantiate that delirium is a frequent occurrence in neurological patients and that the presence of multiple etiologies must be investigated in each patient.
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J Neuropsychiatry Clin Neurosci · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialDose effects of modafinil in sustaining wakefulness in narcolepsy patients with residual evening sleepiness.
Excessive sleepiness associated with narcolepsy lasts throughout the waking day. The authors conducted two randomized, double-blind studies to compare the efficacy of modafinil once-daily versus split doses in maintaining wakefulness throughout the day. ⋯ All modafinil dosing regimens were well tolerated. In patients who experience excessive sleepiness in the late afternoon/evening, despite satisfactory treatment earlier in the day, a split dose of modafinil may promote wakefulness throughout the waking day.
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J Neuropsychiatry Clin Neurosci · Jan 2005
Review Comparative StudyTreatment of acute ischemic stroke: does it impact neuropsychiatric outcome?
Stroke is a leading cause of disability globally. Although neuropsychiatric symptoms are produced by stroke and adversely effect stroke outcome, it is unclear whether neuropsychiatric outcome can be improved by acute stroke treatment. ⋯ Of the 190 trials reviewed, only seven included specific measures of neuropsychiatric outcome, usually a short test of cognition or mood. Further studies are needed to determine the potential benefits of acute stroke treatment on both poststroke neuropsychiatric symptoms and the relationship between such symptoms and stroke outcome.
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J Neuropsychiatry Clin Neurosci · Jan 2005
Comparative StudyDiagnostic criteria for postconcussional syndrome after mild to moderate traumatic brain injury.
This study evaluated the prevalence and specificity of diagnostic criteria for postconcussional syndrome (PCS) in 178 adults with mild to moderate traumatic brain injury (TBI) and 104 with extracranial trauma. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and International Classification of Diseases (ICD-10) criteria for PCS were evaluated 3 months after injury. ⋯ Specificity to TBI was limited because PCS criteria were often fulfilled by patients with extracranial trauma. The authors conclude that further refinement of the DSM-IV and ICD-10 criteria for PCS is needed before these criteria are routinely employed.