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About this product
- Author(s)Aaron E. Miller,Tracy M. DeAngelis
- PublisherOxford University Press Inc
- Date of Publication16/02/2012
- GenreClinical Medicine: Professional
- Series TitleWhat Do I Do Now?
- Place of PublicationNew York
- Country of PublicationUnited States
- ImprintOxford University Press Inc
- Content Note15 B/W
- Weight258 g
- Width141 mm
- Height216 mm
- Spine11 mm
- Table Of Contents1. Multiple Sclerosis ; Multiple Sclerosis (MS), the most common cause of disability due to a neurological disease in young adults, can pose a challenging diagnosis. In this chapter, we summarize the typical symptomatology, radiographic and paraclinical findings in MS. In addition, we briefly review candidate differential diagnostic entities, the current diagnostic criteria, as well as therapeutic options. ; 2. Acute Disseminated Encephalomyelitis ; Acute disseminated encephalomyelitis (ADEM), a fulminant episode of demyelinating disease, which can be confused with a first episode of multiple sclerosis (MS), can present with transiently severe neurological deficits requiring hospitalization and support care. In this chapter, we review the important differential diagnostic and therapeutic considerations and how best to differentiate ADEM from an initial presentation of MS. ; 3. Optic Neuritis ; Optic neuritis (ON), is an ophthalmological syndrome commonly encountered in inflammatory and demyelinating diseases of the central nervous system. Here we review the cardinal clinical examination findings, the possible associated systemic diseases in which ON can manifest, and the recommended diagnostic evaluation and therapeutic measures. ; 4. Transverse Myelitis ; The differential diagnosis of transverse myelitis is lengthy and can present a daunting challenge to the evaluating physician. Emphasizing the critical importance of an initial exclusion of spinal cord compressive causes, we then present several clinical red flags, which can assist in narrowing the potential etiologies and discuss available therapeutic options. ; 5. Neuromyelitis Optica ; Neuromyelitis Optica (NMO), a chronic inflammatory, demyelinating autoimmune disorder of the central nervous system with a predilection for the optic nerves and spinal cord, has long been confused with classical multiple sclerosis. In this chapter, we review the important clinical and radiographic distinctions of NMO and NMO spectrum disorders, as well as a briefly summarize promising new concepts in pathophysiology and therapeutic approaches. ; 6. Pregnancy and Multiple Sclerosis ; The risk of MS relapses is lower during pregnancy but significantly higher in the postpartum period. There are several key management issues to address in women of childbearing age with multiple sclerosis who are pregnant or family planning. In this chapter, we review important therapeutic issues regarding peripartum and postpartum disease management, data regarding the prospect of breastfeeding, and the psychosocial support and counseling to help patients and their families navigate these decisions. ; 7. Progressive Multifocal Leukoencephalopathy and Immune Reconstitution Inflammatory Syndrome ; Progressive Multifocal Leukoencephalopathy (PML), an opportunistic viral infection of central nervous system caused by the JC virus, typically manifests in severely immunocompromised conditions, ranging from HIV/AIDs to lymphoproliferative malignancies to the consequence of immunosuppressant medications, such as natalizumab, a monoclonal antibody approved for the treatment of relapsing forms of MS. In this chapter, we discuss the typical symptomatology and radiographic findings of PML and how to distinguish it from those of MS. In addition, we review the management of PML in natalizumab-treated MS patients as well as the features of immune reconstitution inflammatory syndrone (IRIS), the potentially life threatening consequence of natalizumab withdrawal in patients with PML. ; 8. Neuroborreliosis ; Neuroborreliosis, an infection of the nervous system by the spirochete Borrelia burgdorferi, is a controversial entity both in its proper diagnosis and management. In this chapter, we review the common presentations of Lyme infection affecting the central and peripheral nervous systems, the utility of diagnostic screening and confirmatory tests, and the recommended course of antibiotic treatment. ; 9. HTLV Myelopathy ; Infect
- Author BiographyAaron E. Miller, MD, Medical Director, Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Department of Neurology, Mount Sinai School of Medicine, New York, NY. Tracy M. DeAngelis, Assistant Professor of Neurology, Mount Sinai School of Medicine, New York, NY.
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