Current opinion in neurology
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Curr. Opin. Neurol. · Jun 1995
ReviewAcute disseminated encephalomyelitis and isolated central nervous system demyelinative syndromes.
The clinical and pathological characteristics of acute disseminated encephalomyelitis are briefly outlined. The possible relation between acute disseminated encephalomyelitis and other isolated monophasic inflammatory demyelinating episodes in the central nervous system, such as acute optic neuritis, transverse myelitis or brainstem lesions, is noted and the risk of progression to multiple sclerosis is examined. ⋯ Finally, the risk factors for the progression of demyelinating ther than optic neuritis to multiple sclerosis are explored. Further work to elucidate better the relationships between these pathological entities is suggested.
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A review of the literature dealing with patients presenting with headache caused by underlying disease reinforces the classic teaching that these headaches are hardly ever completely typical of benign syndromes such as migraine. More often than not they are accompanied by features, such as other symptoms or physical abnormalities, that suggest, to the careful clinician, the suspicion of a lesion and the need for investigation.
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Critical care neurology is a rapidly developing subspecialty of neurology. The neuro-intensivist is called upon to manage critically ill patients with stroke, neuromuscular disease, traumatic injury, increased intracranial pressure, and other disorders. Therapeutic and technologic advances are rapidly being incorporated into practice and will improve patient care and outcome.
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Current opinion on "neuropathic" pain is chaotic and divided. This review is a summary attempt at describing the principal hypotheses that are currently entertained and at interpreting the basic underlying mechanisms of these pains. ⋯ Issues such as the concept of "centralization" of neuropathic pain mechanisms, which dwell excessively upon extrapolation from animal experiment to human clinical reality, are highlighted as questionable. Psychogenic pseudoneuropathy, an entity of high clinical prevalence and low appreciation by basic scientists and the reflex sympathetic dystrophy establishment, is also given the emphasis it deserves.
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Curr. Opin. Neurol. · Jun 1994
ReviewContributions of neuroimaging to diagnosis and monitoring of multiple sclerosis.
Recent advances in magnetic resonance neuroimaging have resulted in an increased ability to distinguish acute, potentially reversible lesions from chronic, irreversible lesions in multiple sclerosis. Refinements of magnetic resonance imaging techniques, such as fluid-attenuated inversion recovery, diffusion imaging, and magnetization transfer imaging, as well as magnetic resonance spectroscopic imaging, are providing increased sensitivity and allowing detection of changes in multiple sclerosis white matter that appears normal on standard spin-echo magnetic resonance images. Increased neuroimaging specificity and sensitivity enhance the ability to diagnose, monitor, and understand the progression of multiple sclerosis. Magnetic resonance spectroscopy and magnetic resonance spectroscopic imaging detect metabolites in vivo and have even greater potential for elucidating the biochemical pathology of demyelination in multiple sclerosis.