Showing 21-40 of 78 for: Essential Evidence Topics > Neurologic 
- Dementia (diagnosis)
Essential Evidence Topics, 29-Jul-2020
Overall Bottom Line: The diagnosis rests on clinical criteria but evaluation should include a validated brief cognitive test and laboratory tests focused on treatable causes. Brief cognitive tests for dementia appropriate for office practice include the
- Dementia (Lewy body dementia)
Essential Evidence Topics, 11-Jun-2020
Overall Bottom Line: Dementia with Lewy bodies should be suspected in patients presenting with dementia accompanied by hallucinations, fluctuating cognition, and parkinsonism. Cholinesterase inhibitors are first-line therapy. Avoid typical neuroleptic
- Dementia (multi-infarct)
Essential Evidence Topics, 6-Jun-2020
Overall Bottom Line: In patients suspected of having dementia with vascular risk factors or atherosclerotic disease, neuroimaging showing evidence of brain infarction is highly suggestive of multi-infarct dementia (MID). Cholinesterase inhibitors offer
- Demyelinating diseases of CNS (PML)
Essential Evidence Topics, 14-May-2019
Overall Bottom Line: Suspect progressive multifocal leukoencephalopathy (PML) in immunocompromised patients with gait disorder, limb weakness, visual symptoms, altered mental status, or other neurologic symptoms. If clinically suspected, the diagnosis
- Developmental and intellectual delay (pediatric)
Essential Evidence Topics, 7-May-2020
Overall Bottom Line: Adhere to standard recommendations regarding prenatal and perinatal screening and prenatal, perinatal, and postnatal prevention of mental retardation. The diagnostic yield of clinical assessment ranges from 17.2% to 34.2%. For patie
- Diabetic neuropathy
Essential Evidence Topics, 3-Oct-2019
Overall Bottom Line: Diabetic peripheral neuropathy (DPN) is a major risk factor for foot ulcers and subsequent gait disturbance, falls, and amputations. Persons with diabetes should be screened for DPN at time of diagnosis and annually thereafter using
- Dizziness
Essential Evidence Topics, 13-Dec-2019
Overall Bottom Line: Patients who are older than 70 years, who have a neurological deficit, or lack vertigo should be investigated for a serious cause of dizziness (medication related, neurologic, or cardiac). Perform the Dix-Hallpike maneuver in patien
- Down syndrome
Essential Evidence Topics, 22-Jul-2020
Overall Bottom Line: Serum screening for pregnancy-associated plasma protein A (PAPP-A) and free beta-human chorionic gonadotropin (HCG) with nuchal translucency measurement is an effective first-trimester screen for Down syndrome. Offer invasive genetic
- Encephalitis
Essential Evidence Topics, 10-Apr-2019
Overall Bottom Line: Suspect encephalitis in patients with acute onset of fever, mental status changes, and headache. CSF analysis is essential for diagnosis. All cases of suspected encephalitis should be treated with acyclovir while an etiology is be
- Epidural abscess
Essential Evidence Topics, 13-Dec-2019
Overall Bottom Line: Consider epidural abscess and obtain imaging in patients with back pain and fever or neurologic deficit. Obtain ESR and CRP for patients with back pain and risk factors (diabetes mellitus, IV drug use, indwelling catheter, recent sp
- Fatigue
Essential Evidence Topics, 28-Jul-2020
Overall Bottom Line: Fatigue occurs in up to 20% of patients who seek medical care. Among patients with longstanding fatigue, only one third meet CDC criteria for chronic fatigue syndrome (CFS). A thorough history and physical examination are crucial
- Fragile X syndrome
Essential Evidence Topics, 2-Sep-2019
Overall Bottom Line: Fragile X is the most commonly inherited form of mental retardation. The most common neurobehavioral manifestation is autism spectrum disorder (ASD), which is present in 51% to 67% of males. Genetic testing is recommended for any
- Friedreich ataxia
Essential Evidence Topics, 2-Aug-2020
Overall Bottom Line: Friedreich ataxia typically presents as ataxia in patients aged 5 to 15 years. Genetic testing for the frataxin gene is the reference standard test. A small randomized trial of riluzole found a significantly greater likelihood of
- Guillain-Barré syndrome
Essential Evidence Topics, 10-Jan-2020
Overall Bottom Line: Clinical diagnosis based on the pattern of rapidly evolving paralysis with areflexia, absence of constitutional symptoms, and characteristic antecedent events. Elevated CSF protein and normal WBC are typical, as are abnormalities in
- Headache (cluster)
Essential Evidence Topics, 19-Sep-2018
Overall Bottom Line: Restlessness, nasal congestion, rhinorrhea, and conjunctival injection make cluster headache (CH) more likely, while absence of the following: excruciating pain; unilateral pain; location of pain near eyes, temples or teeth; duration
- Headache (diagnosis)
Essential Evidence Topics, 9-Sep-2020
Overall Bottom Line: Use validated clinical decision rules such as the POUND criteria, ICHD diagnostic criteria and Three-item Migraine Screener to differentiate the three main primary headaches. Use SNNOOP10 mnemonic for secondary causes of headache, a
- Headache (migraine)
Essential Evidence Topics, 11-Sep-2020
Overall Bottom Line: Any severe and recurrent headache is most likely to be a form of migraine and to be responsive to antimigraine therapy. Clinical features most predictive of migraine are nausea, photophobia, phonophobia, and exacerbation by physical
- Headache (tension)
Essential Evidence Topics, 11-Jun-2020
Overall Bottom Line: Patients should be asked about warning signs for concerning intracranial causes of headache such as headache worsening over time, headache changing in character, "thunderclap" headaches, headache worsened by Valsalva maneuver or exert
- Herpes zoster (shingles)
Essential Evidence Topics, 18-Feb-2020
Overall Bottom Line: Typically herpes zoster is characterized by unilateral dermatomal pain and rash. Initiating treatment within 72 hours with appropriate antivirals will significantly decrease the incidence of acute pain but does not appear to decreas
- Huntington disease
Essential Evidence Topics, 4-Jul-2019
Overall Bottom Line: Huntington disease (HD) is an inherited progressive neurodegenerative disorder characterized by choreiform movements, dystonia, psychiatric problems, and dementia. HD affects 5 to 10 per 100,000 of the general population in most Wes
