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PubMed Journal Database | Fortschritte der Neurologie-Psychiatrie RSS

11:32 EDT 25th June 2017 | BioPortfolio

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Showing PubMed Articles 1–25 of 222 from Fortschritte der Neurologie-Psychiatrie

Delirium - a frequent neuropsychiatric complication.

Working and mental illness - Do digitalisation and globalisation make us ill?

Therapy of Hemifacial Spasm with Botulinum Toxin.

Hemifacial spasm (HFS) is a frequent disorder characterized by involuntary contractions of those muscles innervated by the facialis nerve on one side of the face. The symptoms can appear as tonic or clonic, intermittent or permanent. Diagnosis is based purely on clinical observation. Differential diagnosis should rely on cranial MRI, which can demonstrate a pathological contact between the nerves and vessels and exclude alternative causation. Often, the symptoms are not marked so that therapy may not be nec...

Rapid Cycling in Bipolar Disorders: Symptoms, Background and Treatment Recommendations.

Rapid cycling bipolar disorder is encountered frequently in clinical practice with a lifetime prevalence of up to 31 %. Besides its association with greater illness severity, increased suicide and comorbidity rates, rapid cycling bipolar disorder has been closely associated with a longer and more complicated course of disease and inadequate treatment response compared to non-rapid cycling bipolar disorder. However rapid cycling does not serve as a stable characteristic of bipolar disorder, though its prev...

Osmotic Demyelination Syndrome due to Severe Hyponatremia Mimicking Hypoxic Encephalopathy.

Hyponatremia and its rapid correction is a well-known cause of osmotic demyelination most commonly affecting the pons. We report on a case of severe hyponatremia likely due to psychogenic polydipsia resulting in hypotonic hyperhydration with resulting cortical laminar necrosis on initial imaging, mimicking hypoxic brain damage. Pontine myelinolysis became apparent on follow-up imaging, illustrating the diagnostic challenges of extrapontine manifestations of severe hyponatremia.

Medicolegal Assessment of Psychic Sequelae after Minor Traumatic Events.

The majority of medicolegal assessments in claimed psychic sequelae after accidents concerns minor traumatic events. In this case, the focus is on three questions: Was the event appropriate to cause a traumatic disturbance according to current psychiatric classification systems (especially current DSM-5)? Which psychical or physical initial injury can be proven beyond reasonable doubt ("full proof") according to German law? What is the impact of personality characteristics and competing life events in the d...

Neuromodulation for the Treatment of Chronic Pain - What is Useful?

Neuromodulatory techniques have replaced the earlier performed neurolesional procedures to treat chronic pain syndromes with only a few exceptions. Nevertheless these procedures are invasive with respective risks and complications and therefore conservative physical, psychological pharmacological as well as interventional treatments should be performed first. Because this therapy is costly, the indication has to be proven carefully with a strict patient selection and also the long-term results have to be co...

Neuromyelitis optica.

Neurological early rehabilitation and pallation.

Update Opipramol.

Opipramol was developed in the 1960s as an antidepressant and has chemical similarities with tricyclic antidepressants. Pharmacodynamic properties with absent reuptake inhibition of serotonin and noradrenaline and agonism at sigma receptors distinguish opipramol from tricyclics. Furthermore, antidepressive effects are smaller than the anxiolytic ones. The mechanism of action of opipramol is currently not sufficiently understood. Agonistic effects at sigma receptors have been linked with therapeutic effects....

Therapeutic Decisions Concerning Severe Neurological Diseases and at the End of Life.

Modern medicine increasingly enables survival of life-threatening diseases. On the other side, however, especially in Neurology, the questions have to be addressed how intensive the initial treatment should be and how to deal with residual states when severe functional or cognitive deficits are expected. In these cases, it is not only important to decide which medical measures are appropriate for the patient, but also whether, given the prognosis, the patient would agree with the suggested measures. This ar...

The Influence of Caseload on Continuous Treatment with Antidementia Drugs.

Objective The goal of this study is to investigate the impact of the number of dementia cases in general and specialist practices on the continuity of treatment with antidementia drugs. Methodology Period between 2004 and 2013: 1116 general practices, 200 specialist practices, 37 178 dementia cases; observation period: 36 months. Practice groups with 1 - 9, 10 - 20, 21-s49, and ≥ 50 dementia cases. Results The treatment continuity is higher in practices with an average of 150 dementia ca...

Alcohol withdrawal and its major complications.

Delirium tremens is one of the most common complications of alcohol withdrawal. It is potentially lethal and therefore should be detected as early as possible and be monitored and treated intensively. The assessment of risk factors with the Luebeck Alcohol-Withdrawal Risk Scale short form (LARS-11) can help to predict the risk of severe withdrawal adequately. As delirium cannot be differentiated from Wernicke-Encephalopathy with sufficient certainty high parenteral doses of Vitamin B1 and Magnesium orally s...

Gait as the Key Symptom: Neurophysiological Analysis supplements Clinical Diagnosis at First Glance.

Symptom Validation in Independent Medical Evaluations.

High prevalence rates of non-authentic complaints identified by experts in the field of insurance medicine draw attention to the risk of services, which are of limited availability and financially compensated, being used in ways that are not goal-oriented. Therefore, symptom validity testing has become a growing issue to prevent non-targeted monetary compensations. This paper outlines the best-evaluated methods and instruments. Based on the data currently available, their validity, in particular in the cont...

Crossed Aphasia.

Crossed aphasia (CA) is a rare acquired language disorder caused by a right-sided brain lesion in dextrals. Based on a case report, relevant aspects for the diagnosis of CA and differential diagnoses will be outlined. Relevant hypotheses concerning etiology, epidemiology, phenomenology and pathophysiology will be discussed with reference to the literature. The phenomenon of CA has contributed for decades to the development of hypotheses concerning lateralization of cognitive abilities.

Internet- and Mobile Based Psychotherapy for Depression.

Guided Internet- and mobile-based interventions (IMIs) are an effective and scientifically sound treatment option for depression. Meta-analyses revealed effect sizes comparable to those found for face-to-face treatment as well as pharmacotherapy. Today, most IMIs are based on cognitive behavioral therapy (CBT). While IMIs are well established in healthcare systems of many countries worldwide, Germany is still lagging behind. However, there are an increasing number of model projects trying to implement IMIs ...

Side Effects of Occupational Group Therapy.

Background: Occupational therapy is an important co-therapy in psychiatric therapy. It is a common belief that no risks are associated with occupational therapy. Negative effects caused by group therapy, especially occupational therapy, have not been in the focus of research yet. In this study we want to illustrate possible types and intensities of group side effects through occupational therapy. Patients and Methods: Patients of an inpatient rehabilitation facility filled out the Adverse Treatment Reaction...

Integration of Palliative and Hospice Care Structures in the Care of Neurological Patients: Opinion of Chief Consultant Neurologists in Germany.

An online survey of chief neurological consultants was conducted to find out how they judged the demand for and access to palliative and hospice care (PHC) structures for their neurological patients (NP) as well as their collaboration with PHC structures. 110 of 881 chief consultants who were contacted participated in the survey. About 10 % of their NP were considered suitable for PHC. They estimated that 9 % of the deceased had died from their underlying neurological disease. The integration of PHC str...

The Brain-Injured Relationship: Neuropsychological Rehabilitation Counselling and Therapy of Couples and Families.

A brain-injured patient's system of relationships is severely disbalanced, and seeks a new equilibrium very much like a kinetic mobile sculpture responding to an impulse. Thus, it is not only the deficits in the patients and their environment and resources that define the success of participation in the process of rehabilitation. Fundamentally, it relies on stable and adjustable relationships as well as trustful communication in the patients' social systems. Negotiating participation is a concerted, interac...

The Basic-Symptom Concept and its Influence on Current International Research on the Prediction of Psychoses.

The early detection of psychoses has become increasingly relevant in research and clinic. Next to the ultra-high risk (UHR) approach that targets an immediate risk of developing frank psychosis, the basic symptom approach that targets the earliest possible detection of the developing disorder is being increasingly used worldwide. The present review gives an introduction to the development and basic assumptions of the basic symptom concept, summarizes the results of studies on the specificity of basic sympto...

Chronic Inflammatory Demyelinating Polyneuropathy.

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic progressive or relapsing autoimmune neuropathy with heterogeneous clinical presentation. Symptoms typically include symmetrical, proximal and/or distal paresis and sensory loss. Atypical CIDP variants are increasingly recognized, including subtypes with rapid onset as well as variants with pure sensory, focal or marked asymmetrical deficits. Diagnosis is established by compatible symptoms, characteristic electrophysiological features and ...


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