Drawing upon the knowledge of expert contributors, this book provides an introduction to what CAM therapies are and how a neurologist may use them. Divided into two sections, it reviews the different kinds of therapies encompassed by the terms "alternative" and "complementary" and gives readers an overview of commonly used therapies that have some scientific basis for their use.
Harrison's Internal Medicine Chapter 97. Paraneoplastic Neurologic Syndromes
Paraneoplastic Neurologic Syndromes: Introduction
Paraneoplastic neurologic disorders (PNDs) are cancer-related syndromes that can affect any part of the nervous system (Table 97-1). They are remote effects of cancer, caused by mechanisms other than metastasis or by any of the complications of cancer such as coagulopathy, stroke, metabolic and nutritional conditions, infections, and side effects of cancer therapy. In 60% of patients the neurologic symptoms precede the cancer diagnosis.
Inflammation can also be found in the intervertebral disks resulting in discitis and
spondylitis, which can be seen as narrowing of the intervertebral space and destruction of
the adjacent cover plates. Seldom synovitis and osteitis can be found in the atlantoaxial area
leading to erosions and destruction of the lateral atlantoaxial joint. At the worst the joint is
destabilized, this may cause cord compression and neurological loss of function.
Apoptosis in the developing nervous system results in naturally occurring
cell death (NOCD), a necessary and desirable process. NOCD effectively
eliminates neurons that have made faulty synapses or have not reached
In the rest of the organism, apoptosis is essential for
organogenesis, sculpts digits and extremities, and plays a role in determining
polarity of structures by contributing to directional growth of cell populations.
Failure of carefully orchestrated and effective apoptosis in the developing
fetus can have serious and long-lasting effects in the adult.
Paraneoplastic neurologic disorders (PNDs) are cancer-related syndromes that can affect any part of the nervous system (Table 97-1). They are remote effects of cancer, caused by mechanisms other than metastasis or by any of the complications of cancer such as coagulopathy, stroke, metabolic and nutritional conditions, infections, and side effects of cancer therapy. In 60% of patients the neurologic symptoms precede the cancer diagnosis. Overall, clinically disabling PNDs occur in 0.
James Parkinson described Parkinson’s disease in his memorable Essay on the Shaking Palsy in 1817. Since then,
and particularly in recent years, there has been tremendous progress in our understanding of this complex and fascinating
neurological disorder. Briefly, we have learned that it is not only manifest by motor symptoms but also
that there is a whole range of non-motor features, including autonomic, psychiatric, cognitive and sensory impairments.
We now know how to distinguish better clinically between Parkinson’s disease and the various parkinsonian
About four out of five people in low- and middle-income
countries who need services for mental, neurological and
substance use conditions do not receive them. Even when
available, the interventions often are neither evidence-based nor
of high quality. WHO recently launched the mental health Gap
Action Programme (mhGAP) for low- and middle-income countries
with the objective of scaling up care for mental, neurological and
substance use disorders.
Surgical education is changing. Mandates that foster this change include increasing
demands from the public for perfection without practice, decreasing
trainee work hours, increasing minimally invasive therapies, and fewer surgical
educators. In addition, rising health care costs have caused many experienced
surgeons to focus on patient care rather than the mentoring of surgical trainees. A
paradigm shift in surgical education is being forced by all these issues.
The veterinary profession has made major diagnostic and
therapeutic advances in the treatment of infectious and
degenerative diseases. The incidence of chronic disease
and cancer, however, has increased at alarming rates and
is diagnosed at younger ages, even in puppies and kittens.
Perhaps it is this rising incidence of degenerative diseases
that has spawned an insatiable search by professionals,
scientists, and animal guardians for alternative therapies.
During the last decades, numerous studies about stem cells and regenerative medicine highlighted new therapeutic approaches to treat several neurological disorders. It is noteworthy that the current optimism over potential stem cell therapies is driven by new understandings of stem cell biology leading to specific cell fate decision.
Mucopolysaccharidosis type I (MPS I) results from a deﬁciency in the enzyme a-L-iduronidase (IDUA), and is characterized by skeletal abnormalities, hepatosplenomegaly and neurological dysfunction. In this study, we used a late generation lentiviral vector to evaluate the utility of this vector system for the transfer and expression of the human IDUA cDNA in MPS I ﬁbroblasts. We observed that the level of enzyme expression in transduced cells was 1.5-fold the level found in normal cells; the expression persisted for at least two months....
Over the past few decades the field of neurology has seen spectacular developments in diagnostic techniques, most vividly
exemplified by modern neuroimaging and molecular genetics. Although not always at the same speed this evolution has
gone hand in hand with an enlarging armentarium of effective therapies to treat neurological disease.
PARKSERVICE is a new telemedical application combining home-based support for
people with Parkinson’s disease (PD) and a PD-specific walking aid which uses a
strategy known as visual cueing. PD is estimated to affect 100-180 per 100,000 of the
population (with most surveys favoring the higher estimate) and has an annual
incidence of 4-20 per 100,000,. Taking a population of approximately 450M
citizens this implies 450,000-900,000 people with PD (PWP) in the EU.
Palliation Surgery is employed in a number of ways for supportive care: insertion of central venous catheters, control of pleural and pericardial effusions and ascites, caval interruption for recurrent pulmonary emboli, stabilization of cancerweakened weight-bearing bones, and control of hemorrhage, among others. Surgical bypass of gastrointestinal, urinary tract, or biliary tree obstruction can alleviate symptoms and prolong survival. Surgical procedures may provide relief of otherwise intractable pain or reverse neurologic dysfunction (cord decompression).
This book is written for physical therapists, physical therapy students, and
related health professionals. It is a clinical guide for the assessment of
patients with neuromuscular disorders. Please use the tables in the INTRO
tab to quickly find information on specific diseases/disorders or test and
In addition to the content you’ll find here, we have also provided bonus
content on the DavisPlus Web site for this book.
Movement disorders represent major causes of neurological disability and
eventual mortality affecting millions of people across the globe. From
Parkinson’s disease to spasticity, these neurological disorders devastate
young and old worldwide. While progress continues to be made toward
effective treatment, many limitations remain.
The combination of the limitation of medical therapy and surgical
technological advances have, however, led to an exponential growth in functional
neurosurgery in the last 5 years.