Spotlight on Affective disorders in neurologic disease

In this article, Dr. Sergio Starkstein of the University of Western Australia and Dr. Jaime Pahissa of the Instituto Universitario CEMIC review the frequency, diagnostic strategies, clinical correlates, mechanism, differential diagnoses, and management of affective disorders in frequent acute and chronic neurologic disorders, such as stroke, traumatic brain injury, dementia, Parkinson disease, Huntington disease, multiple sclerosis, and epilepsy. Studies using sophisticated neuroimaging techniques have provided important clues regarding the mechanism of depression and disinhibition in neurologic conditions. Randomized clinical trials have been reported for depression in stroke, Parkinson disease, and Alzheimer disease as well as for the prevention of depression after stroke.

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Spotlight on Alzheimer disease

Alzheimer disease is the prototypical and, by far, most common dementia. In this clinical summary, Dr. David S Geldmacher, Director of the Division of Memory Disorders and Behavioral Neurology at the University of Alabama at Birmingham, presents an overview of the disease including clinical manifestations, pathophysiology, etiology, and diagnostic workup. Also included is information on recent results from clinical trials of exercise and treatments for neuropsychiatric symptoms.

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MedLink Neurology authors are always at work to bring you broad and up-to-date coverage of neurology topics. We are pleased to highlight clinical summaries that have been recently added or updated and to introduce the authors who write these authoritative articles. We hope you enjoy these overviews and appreciate the contributions of our more than 450 authors who keep MedLink Neurology the premier information resource for neurologists.

Spotlight on Sleep and dementia

Disordered sleep and dementia are 2 neurologic issues that are found in many of the same patients and may, indeed, interact. In dementia, degeneration of central sleep-wake mechanisms frequently leads to sleepiness and insomnia with sundowning. REM sleep behavior disorder can herald a synucleinopathy. In some cases, sleep apnea might result from degeneration of medullary respiratory centers. The treatment of sleepiness and insomnia with sundowning is not well-established, as many medications have risks that outweigh their benefits; however, REM sleep behavior disorder often responds to clonazepam, and continuous positive airway pressure therapy can improve cognition in some cases of obstructive sleep apnea. In this clinical summary, Dr. Kyoung Bin Im and Dr. HyungSub Shim of the University of Iowa review these interactions, including recent updates on REM sleep behavior disorder.

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MedLink Neurology authors are always at work to bring you broad and up-to-date coverage of neurology topics. We are pleased to highlight clinical summaries that have been recently added or updated and to introduce the authors who write these authoritative articles. We hope you enjoy these overviews and appreciate the contributions of our more than 450 authors who keep MedLink Neurology the premier information resource for neurologists.

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Spotlight on Dementia with Lewy bodies

Dementia with Lewy bodies is second only to Alzheimer disease as the most frequent cause of neurodegenerative dementia and accounts for approximately 20% of cases in the elderly. It is clinically characterized by any combination of cognitive impairment (especially deficits of attention, executive function, or visuospatial function), fluctuations of cognition, recurrent visual hallucinations, and spontaneous motor features of parkinsonism. The diagnosis of dementia with Lewy bodies may be difficult, especially early in the course, as the clinical features are variable among individual patients. Recognition of dementia with Lewy bodies is important, as patients are at increased risk of sensitivity to certain medications such as neuroleptics and anticholinergics, which can lead to increased morbidity and mortality in this population.

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MedLink Neurology authors are always at work to bring you broad and up-to-date coverage of neurology topics. We are pleased to highlight clinical summaries that have been recently added or updated and to introduce the authors who write these authoritative articles. We hope you enjoy these overviews and appreciate the contributions of our more than 450 authors who keep MedLink Neurology the premier information resource for neurologists.

Spotlight on Familial Alzheimer disease

Alzheimer disease is the most common cause of late-life dementia; it can begin either in individuals aged 65 years or younger (early onset) or after the age of 65 years (late onset). It can also be classified as familial or sporadic. Those instances in which a clear pattern of inheritance within a family is established are termed “familial Alzheimer disease.” Such cases do not seem to be different from those with the sporadic form of this illness. In this clinical summary, Dr. Francisco Lopera discusses the genetic aspects of familial Alzheimer disease, and in the most recent update, he addresses new evidence of clinical heterogeneity in the disease and new loci of genetic risk factors for Alzheimer disease: TOMM40, the clusterin (CLU) or APOJ gene, and the PICALM gene.

To view the complete clinical summary, click here.

MedLink Neurology authors are always at work to bring you broad and up-to-date coverage of neurology topics. We are pleased to highlight clinical summaries that have been recently added or updated and to introduce the authors who write these authoritative articles. We hope you enjoy these overviews and appreciate the contributions of our more than 450 authors who keep MedLink Neurology the premier information resource for neurologists.