Parainfectious disorders of the nervous system encompass those meningo-encephalo-radiculomyelitic conditions that are temporally associated with a systemic infection, antigenic stimuli, or toxin exposure, in the absence of evidence of direct neuronal infection or invasion of the central nervous system (CNS) or peripheral nervous system (PNS). Pathogenetic mechanisms can be due to immune-mediated processes (such as bystander activation, molecular mimicy) or the inciting insult can be due to toxic factors, as in the case of botulism. A myriad of clinical manifestations can occur including headache, seizures, and mental status changes, ranging from mood and behavioral disturbances to varying levels of alteration in consciousness. Focal neurological deficits can include aphasia, hemiparesis, or paraparesis. The PNS can also be affected leading to cranial nerve involvement, focal or multifocal neuropathies, and dysfunction of the autonomic nervous system. Diagnosis is based not only on the history, examination, laboratory, and neuroimaging data but also on epidemiological factors. The parainfectious disorders covered in this review are cat scratch disease, Lyme borreliosis, legionellosis, brucellosis, botulism, pertussis, and mycoplasma. Each is associated with a distinct organism, has both systemic and neurological manifestations, and has a different epidemiological profile.
This practical guide for physicians and other health care professionals discusses the impact of fatigue on the individual with MS, the potential etiologies underlying MS-related fatigue, its work up and diagnosis, and pharmacologic and nonpharmacologic management strategies. Fatigue is perhaps the single most prevalent and disabling symptom of the multiple sclerosis, and limits patients' activity more than any other MS symptom. The identification of fatigue as a distinct clinical entity requires both art and science, and most of all, a willingness and ability to listen carefully to patients and their families. The physician's ability to obtain a comprehensive history requires a full understanding of the circumstances in which fatigue occurs (physical, cognitive, and psychosocial) and demands consideration of a large number of disorders, including anxiety, depression, excessive daytime sleepiness, pain, and spasticity, all of which may mimic or contribute to fatigue. While fatigue is almost exclusively a subjective experience, depending on the patient's ability to understand and report this symptom, there are effective methods for identifying the existence of fatigue, determining its severity, and distinguishing it from related or contributing disorders such as depression, pain, and sleep disorders. Readers will learn that fatigue need not be tolerated by the MS patient. Various therapies, support systems, and treatment of underlying affective disorders can all alleviate fatigue or reduce its impact, restoring the patient's energy levels and ability to participate in life. Virtually every MS patient with fatigue can benefit from intervention, and failing to treat the symptom of fatigue with the respect that it deserves is a serious detriment to patient care.
Only 4 1/2" by 6", this clinical handbook in The Most Common Complaints series fits easily into a pocket or lab coat for quick reference. The author presents a general overview and brief descriptions of the current theories on the causes of fatigue, and detailed guidelines for diagnosis and treatment. Readers will find to-the-point discussions of the pathophysiology of fatigue and clinical aspects of common disorders. This book is a must have for the proper diagnosis and appropriate treatment of this challenging clinical problem. Discusses the hottest topics in the field, such as fatigue co-variables · multiple sclerosis · chronic fatigue syndrome · Lyme disease · HIV infection · and current treatment approaches. Features a concise, well-organized format for easy access to information. Includes key point boxes for a quick reference by the busy clinician.
This practical guide for physicians and other health care professionals discusses the impact of fatigue on the individual with MS, the potential etiologies underlying MS-related fatigue, its work up and diagnosis, and pharmacologic and nonpharmacologic management strategies. Fatigue is perhaps the single most prevalent and disabling symptom of the multiple sclerosis, and limits patients' activity more than any other MS symptom. The identification of fatigue as a distinct clinical entity requires both art and science, and most of all, a willingness and ability to listen carefully to patients and their families. The physician's ability to obtain a comprehensive history requires a full understanding of the circumstances in which fatigue occurs (physical, cognitive, and psychosocial) and demands consideration of a large number of disorders, including anxiety, depression, excessive daytime sleepiness, pain, and spasticity, all of which may mimic or contribute to fatigue. While fatigue is almost exclusively a subjective experience, depending on the patient's ability to understand and report this symptom, there are effective methods for identifying the existence of fatigue, determining its severity, and distinguishing it from related or contributing disorders such as depression, pain, and sleep disorders. Readers will learn that fatigue need not be tolerated by the MS patient. Various therapies, support systems, and treatment of underlying affective disorders can all alleviate fatigue or reduce its impact, restoring the patient's energy levels and ability to participate in life. Virtually every MS patient with fatigue can benefit from intervention, and failing to treat the symptom of fatigue with the respect that it deserves is a serious detriment to patient care.
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