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Neurology

Primary care on front line for atrial fibrillation

May 22, 2009

Diagnosing atrial fibrillation could sharply reduce strokes in the United States, and primary-care physicians have a key role to play, according to experts at the American College of Cardiology.

Secondary stroke prevention lags

April 07, 2009

Even as researchers are fine-tuning approaches to preventing primary coronary events, a new analysis of unrelated CDC data found that primary-care providers need to focus more on secondary stroke prevention too.

New aspirin guidelines stress gender differences

By Myra Dembrow April 06, 2009

Men and women don't respond the same to prophylactic aspirin therapy. Updated recommendations from the U.S. Preventive Services addresses this aspect of heart disease prevention.

Waist size beats BMI in predicting stroke and TIA

February 26, 2009

Waist-to-hip ratio and other measures of abdominal obesity are better indicators of cerebrovascular risk than BMI, according to a new study.

Antidepressants ease fibromyalgia complaints

By Myra Dembrow February 05, 2009

Antidepressants are effective against most symptoms, a meta-analysis of clinical trials reports.

Ginkgo biloba does not prevent dementia, says study

January 25, 2009

Findings from a large, long-term study dispel the notion that ginkgo biloba—a popular herbal supplement widely purported to improve memory and cognition—prevents dementia or Alzheimer's disease.

Three clinical factors aid TIA detection

January 22, 2009

Transient ischemic attacks can be difficult to diagnose because the symptoms are often gone by the time the patient seeks medical help. Plus, those symptoms can mimic other disorders.

Recognizing bacterial meningitis

By Cedric W. Spak, MD, MPH January 06, 2009

Bacterial infection of the meninges is potentially treatable if diagnosed early, making rapid diagnostics essential and increasing pressure on the clinician.

Treating Bell's palsy in pregnancy

Asked by Shailendra K. Saxena, MD, PhD, Omaha; answered by Daniel R. Mishell Jr, MD, and Jay E. Selman, MD November 21, 2008

I recently saw a 26-year-old woman in my clinic with right-sided Bell's palsy. However, the patient was three weeks pregnant. What are the options for treating Bell's palsy in early pregnancy? Is it safe to use steroids or acyclovir in the first trimester?

Osteoarthritis turns out to be much more

CASE AND ANALYSIS BY JACK WAXMAN, MD August 01, 2008

A condition that seemed to be under control flares, with painful complications.

Traumatic brain injury

Question raised by Felix N Chien, DO and answered by Jay E. Selman April 17, 2008

What is the connection between a singular traumatic brain injury (TBI) and long-term loss of cognitive function, i.e., processing and memory? If the connection is tenuous, why is there continued focus on TBI?

Chronic fatigue syndrome finally gains respect

By Nelly Edmondson Gupta March 14, 2008

It is a real diagnosis, says the CDC. We interviewed three experts to find out what primary-care clinicians can realistically do to help these patients.

Facial papules and truncal macules accompanied by seizures

By Craig N. Burkhart, MD, MS June 07, 2007

A 13-year-old male requested treatment of multiple erythematous facial papules, 1-2 mm in diameter. The lesions first appeared when he was 5 years old and have continued to develop on his face. They do not respond to OTC acne medications....

Counterbalancing haloperidol

Submitted by Theodor W. Pesch, MD, Wilmington, Del. March 14, 2007

If you use IV haloperidol (Haldol) for migraine headache, consider using diphenhydramine (Benadryl) as well to decrease the likelihood of extrapyramidal effects.

7 steps for treating chronic pain

By Matt Hollon, MD, MPH November 03, 2006

Primary-care physicians are treating more and more patients who suffer from chronic pain. Here we offer an easy-to-follow guide that will help give those patients some relief.

ADHD: Not just for kids

By Lenard Adler, MD October 12, 2006

Symptoms of ADHD can persist into adulthood and cause impairment in every realm of life, including employment and family responsibilities.

Migraine and tension headache link?

Question raised by Craig Freyer, MD, Fort Worth, Texas, and answered by Daniel G. Tobin, MD July 07, 2006

Some headache studies imply that migraine and tension headaches may simply be different presentations of the same headache syndrome. And GlaxoSmithKline has data on relief of tension headache with sumatriptan (Imitrex). Is this class of drugs useful for tension headache? If so, why haven't they been submitted to the FDA for that indication?

Perimenopausal migraine prophylaxis

Question raised by Paula Y. Carruthers, MD, Sherman Oaks, Calif. and answered by Douglas Dulli, MD, associate professor of neurology, University of Wisconsin Medical School, Madison May 06, 2006

How well does standard migraine prophylaxis work in perimenopausal women averse to hormone therapy?

Hemiparesis, headache, and dysphasia strike a traveler

John R. Pettinato, DO February 20, 2006

The symptoms suggested stroke, but then the author began to suspect an even worse possibility.

Worsening right upper-quadrant pain strikes a young woman

BARBARA A. MAJERONI, MD February 20, 2006

A hard landing after a fall exacerbates the pain and results in the patient's serendipitous return to the ER.

What physicians can do for restless legs syndrome

JAY E. SELMAN, M.D February 20, 2006

There are more options than ever, including numerous medications. A neurologist tells how to select the best therapy for each patient.

Finding Alzheimer's: A proactive approach means early help

By Douglas Trenkle, DO February 16, 2006

For many years, I believed that Alzheimer's disease (AD) was irreversible and, at best, marginally treatable. I also felt that even if we could diagnose AD before a patient's cognitive function markedly declined, there was little point in doing so.