New CME Series

Appropriate Management of Multiple Sclerosis in Primary Care

  • Diagnosing MS: Recognizing Common Symptoms and Interpreting MRI Results
  • Developing a Therapeutic Plan for MS: Evidence for New Treatments

Restless Legs Syndrome: Recognition, Diagnosis, and Treatment of a Common Sleep Disorder

  • Recognizing the Features and Presentations of RLS
  • Common Comorbidities and Differential Diagnosis of RLS
  • Latest Guidelines and Advances for Treatment of RLS

See all Neurology Reports

FEATURED ARTICLES

Can people become addicted to suicidal behavior? Do individuals who attempt suicide 5 times or more represent a distinct phenotype among those with suicidal behavior? In this CME article, discover the demographic and clinical characteristics of patients who repeatedly attempt suicide.

Read about the case of Mr A, a 51-year-old former musician with chronic alcoholism and multiple inpatient rehabilitation stays for addiction counseling and detoxification. The authors discuss pharmacologic, affective, behavioral, and cognitive interventions for alcohol use disorders and provide guidelines for physicians when treating these patients.

Diagnose and manage Ms A, an 84-year-old woman who was first noted to have cognitive changes after surgery 1 year ago. She is increasingly repetitive and no longer able to manage her finances. Ms A has had no changes in self-care and manages her own medications, but her daughter believes that she occasionally misses a dose.

See all Alzheimer's Disease

ALZHEIMER'S DISEASE

Have any patients come to you with vision problems that their eye doctors can't solve? Read this interactive case report to learn how these symptoms may be indicative of a variant of Alzheimer's disease.

This article presents a practical, evidence-based, expert opinion regarding the role of the primary care physician in the assessment and management of dementia due to Alzheimer’s disease. The recommendations presented here are based on the most current guidelines and consensus documents available.

In this CME series, find out about the presentation and differential diagnosis of Alzheimer’s disease, get an expert review of the pathology of this illness, and discover how to develop a management plan to optimize your patients’ outcomes.

See all Autism

AUTISM

Autistic disorder is characterized by qualitative impairments in reciprocal social interaction, verbal and nonverbal communication, among other characteristics.

Autism is a neurodevelopmental disorder with childhood onset characterized by atypical developments.

See all Dementia

DEMENTIA

Capgras’ syndrome is a disorder in which a person holds a delusion that a close relative like a spouse or parent has been replaced by an identical looking imposter. Read about a case of Capgras’ syndrome in an 80-year-old man with dementia.

Have you tried treating hypersexuality in patients with dementia? Although up to a fifth of patients with dementia have sexually disinhibited behaviors, no approved treatments are available. Engage in this case study to learn treatment ideas from experts at the Banner Alzheimer's Institute.

Severe hyponatremia can result in confusion, delirium, seizures, and, ultimately, death. Here, review a case of an anxious man whose self-treatment of anxiety with an herbal beverage containing valerian root worsened hyponatremia.

See all Headache

HEADACHE

A vast array of idiopathic somatic complaints are common among depressed persons across the lifespan.

Headaches account for a high percentage of office visits to primary care physicians.

See all Movement Disorders

MOVEMENT DISORDERS

Comprehensive Behavior Intervention for Tics (CBIT) is a safer and effective alternative to antipsychotics for the treatment of Tourette’s disorder. This report describes the case of a 5-year-old child with Tourette’s disorder who benefited from the components of CBIT.

Tardive dyskinesia is a well-known side effect of conventional antipsychotics. Fluvoxamine may be an effective treatment for neuropsychiatric disorders via sigma-1 receptor agonism. Here, Albayrak and colleagues report 5 cases in which fluvoxamine was beneficial for both postpsychotic depressive disorder and tardive dyskinesia in patients with schizophrenia.

Read about the case of a 60-year-old woman who developed a disabling intention tremor in her hands, head, and jaw 2 months after aripiprazole was added to lamotrigine treatment.

See all Multiple Sclerosis

MULTIPLE SCLEROSIS

In this CME series, learn about the efficacy and safety of IM, IV, and oral MS treatments, find out how to monitor your patients and choose the best switching strategies, and discover unmet needs in the treatment of progressive forms of MS.

Are you familiar with the most common pain syndromes associated with MS? In this Neurology Report, review central neuropathic and nociceptive pain symptoms frequently experienced by patients with MS, and learn which evidence-based treatments are appropriate for each type of pain.

Do you know the safety and risk management obligations when prescribing opioids for chronic pain? Review the use of opioids in pain management and learn about tools and methods that can help you assess patients for abuse risk and safeguard them during treatment.

See all Other

OTHER

In this Letter to the Editor, review the case of Ms A, a 27-year-old pregnant woman who experienced shortness of breath, chest pain, and multiple episodes of unresponsiveness. The diagnosis of psychogenic non-epileptic seizures was made and discussed with Ms A and her husband.

Read about the neuropsychiatric profiles of 2 adult patients with Williams syndrome, a rare genetic disorder, and co-occurring generalized anxiety disorder and depressive symptoms. Then, get an overview of their anxiety profiles and the pharmacologic interventions that were used.

Have you been uncertain about the indications for and the risks of various neuroimaging modalities? Have you been perplexed by which test to order first? If you have, then this case presentation and discussion should prove useful.

See all Pain

PAIN

Here, review results from a 10-week study that compared the pain-relieving effects of milnacipran, a serotonin-norepinephrine reuptake inhibitor, to that of placebo in patients with lumbosacral disc disease. Nerve pain in the legs was studied in addition to tissue pain in the lumbar spine.

The authors of this study examined relationships between borderline personality symptomatology, pain, and pain catastrophizing. Confirmation of these relationships might lead to focused and effective interventions in patients with chronic pain and borderline personality disorder.

Read about the case of Mr A, a 70-year-old man who was diagnosed with amyotrophic lateral sclerosis, a terminal illness that progresses through loss of function to death without hope of a cure. Dr Schuyler explains how a brief psychotherapeutic intervention helped Mr A cope with this difficult illness and life stage.

See all Parkinson's Disease

PARKINSON'S DISEASE

The authors of this Letter to the Editor report 4 cases of long-term chronic pain that improved dramatically following administration of aripiprazole, a partial dopamine agonist.

Read about the case of Mr A, a 41-year-old patient with Parkinson’s disease who presented in a mental health clinic after experiencing new-onset compulsive behavior with the dopamine agonist ropinirole. For the past few months, he was having intense sexual desires, an increase in appetite, and had started gambling.

This Letter to the Editor describes the case of Ms A, a 64-year-old patient in a skilled nursing facility whose psychotic symptoms completely remitted with a combination of aripiprazole and divalproex. She also experienced improvement in Parkinson’s disease symptoms, specifically tremor and akinesia.

See all Sleep

SLEEP

Before this study, the safety and efficacy of trazodone and quetiapine for sleep had never been contrasted in one study. Doroudgar and colleagues compared and contrasted trazodone with quetiapine in an inpatient psychiatric setting by looking at various sleep parameters and patient reported side-effects.

Sleep disorders are common in the veteran population, and there is an increasing need for sleep medicine services for returning veterans. Read this article to learn about a pilot project for primary care–sleep medicine integration established at the Minneapolis VA Medical Center.

Learn about the state of the art in treatments for insomnia, new research into understanding the sleep-wake cycle, including the role of GABA and orexin systems in regulating both sleep and wakefulness, and how that research might play out in treatments for insomnia.

See all Stroke

STROKE

Have you ever wondered how people cope with the devastating sequelae of strokes?

We read with interest the recenetly published discussion concerning the use of atypical antipsychotic medications in the primary care setting.

Is it reasonable to assume that just about everyone becomes depressed following a stroke?

SUBSTANCE ABUSE/ALCOHOLISM

See all Substance Abuse/Alcoholism

How can prescription drug misuse be prevented? Sowa and colleagues investigated the value of a prescription monitoring program in identifying prescription drug misuse among patients presenting to a resident physicians’ outpatient psychiatry clinic.

Review the case of Mr A, a 53-year-old man who presented at the emergency room after consuming 2 large bottles of mouthwash. He said that voices in his head were telling him to kill himself.

How can you help to diminish the epidemic of prescription drug abuse? Learn why prescription drug monitoring program databases are powerful tools to recognize high frequencies of patient exposure to prescribed opioids and other drugs that are frequently abused.