Showing 61-78 of 78 for: Essential Evidence Topics > Neurologic 
- REM sleep behavior disorder (RBD)
Essential Evidence Topics, 10-Jul-2021
Overall Bottom Line: Suspect rapid eye movement sleep behavior disorder (RBD) in patients who report movements during sleep or "acting out their dreams." A simple one-item screening question is highly accurate. A history of REM sleep behavior disorder m
- Restless leg syndrome
Essential Evidence Topics, 7-Jun-2019
Overall Bottom Line: Restless legs syndrome (RLS) is a clinical diagnosis based on four diagnostic criteria: (1) urge to move legs, usually associated with uncomfortable or unpleasant sensations; (2) symptoms begin or worsen during periods of rest or inac
- Seizure disorder (adult)
Essential Evidence Topics, 10-Jul-2021
Overall Bottom Line: Although the diagnosis of a seizure or epilepsy remains at heart clinical, supportive diagnostic tests including a neuroimage and EEG have significant yield and impact on prognosis for seizure recurrence. Initiate antiepileptic mono
- Seizure disorder (childhood)
Essential Evidence Topics, 23-Sep-2021
Overall Bottom Line: Order emergent neuroimaging if the child has a focal deficit that does not resolve or if he or she does not return to baseline mental status. Consider neuroimaging if focal or prolonged seizure, baseline neurological deficits of unk
- Seizures (febrile)
Essential Evidence Topics, 10-Jul-2021
Overall Bottom Line: Febrile seizures are isolated, self limiting, non-epileptic seizures in children (ages 6 months to 5 years) associated with febrile illness. Febrile seizures alone do not lead to motor or cognitive defects. Anticonvulsant therapy is
- Speech problem and delay
Essential Evidence Topics, 9-Aug-2021
Overall Bottom Line: There is insufficient evidence to recommend for or against the routine use of brief, formal screening instruments to detect speech and language delay in children up to 5 years of age. Refer children younger than 3 years with suspect
- Spinal cord injury
Essential Evidence Topics, 1-Feb-2021
Overall Bottom Line: Midline cervical tenderness is the most reliable cervical spine injury sign; validated clinical rules such as NEXUS and the Canadian C-spine rules exist to guide imaging. Spinal immobilization until extent of injuries has been radio
- Spinal muscular atrophy
Essential Evidence Topics, 10-Jul-2021
Overall Bottom Line: Genetic testing for spinal muscular atrophy (SMA) may be done to predict the risk of disease with related offspring but is not routinely recommended. Any child with delay in achieving motor developmental milestones should be evaluat
- Status epilepticus
Essential Evidence Topics, 10-Jul-2021
Overall Bottom Line: Although status epilepticus is traditionally defined as a seizure lasting more than 30 minutes, or repeated seizures between which consciousness is not fully regained, any seizure lasting more than 5 minutes is unlikely to cease spont
- Subclavian steal syndrome
Essential Evidence Topics, 6-Sep-2020
Overall Bottom Line: A difference of more than 15 mm Hg blood pressure between arms suggests the presence of subclavian artery stenosis (SAS). Color Doppler ultrasound is the recommended initial test. Percutaneous transluminal angioplasty with subclav
- Syncope
Essential Evidence Topics, 10-Jul-2021
Overall Bottom Line: Initial evaluation should include a careful history and physical examination and an ECG. CNS imaging, echocardiogram, and Holter monitoring are not indicated for all patients and should be guided by specific findings of the history
- Tardive dyskinesia
Essential Evidence Topics, 10-Jul-2021
Overall Bottom Line: Use neuroleptics only in patients who cannot use other medications and use doses as low as possible. There is some evidence that new antipsychotics may be less likely to cause tardive dyskinesia (TD). Screen patients taking neurol
- Thoracic outlet syndrome
Essential Evidence Topics, 11-Oct-2019
Overall Bottom Line: Use provocative maneuvers to elicit symptoms of thoracic outlet syndrome (TOS). Urgent evaluation of vascular abnormalities should be performed with Doppler ultrasound. MRI gives adequate information for all types of TOS and can h
- Torticollis
Essential Evidence Topics, 10-Dec-2019
Overall Bottom Line: Suspect torticollis in a patient with involuntary posturing of the head with or without pain. Consider further diagnostic evaluation if an underlying primary cause for the torticollis is suspected (patient with signs of mass, infect
- Tourette syndrome
Essential Evidence Topics, 2-Jul-2020
Overall Bottom Line: Tourette syndrome (TS) is a hereditary neurological disorder characterized by multiple motor and 1 or more phonic tics, usually beginning in childhood. Diagnosis is clinical, relying on the identification of tics, and differentiatin
- Traumatic brain injury
Essential Evidence Topics, 30-Nov-2020
Overall Bottom Line: In the acute setting, prompt identification and aggressive management of neurological and medical complications are thought to improve traumatic brain injury (TBI) outcomes. Following acute hospitalization, patients should transitio
- Tremor (essential or familial)
Essential Evidence Topics, 26-Jul-2021
Overall Bottom Line: The diagnosis of essential tremor (ET) is clinical; diagnostic testing is generally not needed. A strong family history is suggestive of ET. Propranolol and primidone are first-line treatments; second-line treatments include ate
- Trigeminal neuralgia
Essential Evidence Topics, 8-Sep-2021
Overall Bottom Line: Trigeminal neuralgia (TN) is diagnosed clinically on the basis of recurrent attacks of unilateral severe facial pain; it can by primary/idiopathic which is caused by neurovascular contact with the nerve, or secondary TN. Order MRI w
