Neurology Consultations Archive

Testing for closed head injury

What is a good screening test for evaluation of closed head injury?

Reducing intracranial pressure after head injury

Does the concentration of hypertonic saline affect intracranial pressure reduction in patients with traumatic brain injury?

Treating a paranoiac for dementia

What is the recommended treatment for patients diagnosed with dementia who are suffering with paranoia and/or hallucinations?

When to advise palliative care

When do patients benefit most from palliative care consults?

Osteoporosis in a patient taking anti-seizure medication‚Ä©

Are dual-energy x ray absorptiometry scans safe for patients taking anti-seizure medication?

When is surgical intervention advisable for Parkinson disease?

Is there a window of opportunity when surgical intervention is most successful for patient's with Parkinson disease?

Decreasing secretions following tracheostomy

A patient with a tracheostomy for severe obstructive sleep apnea has not responded to several treatments to decrease secretions from the plastic tube. What's the next step?

Vitamin B12 deficiency in older adults

Should testing for vitamin B12 deficiency be part of a standard geriatric workup?

Halting migraine in someone with coronary artery disease

What treatment would you recommend for aborting a migraine in a patient with known coronary artery disease?

Confirming suspicions of hepatic encephalopathy

A patient is suspected of having hepatic encephalopathy (HE) attributable to liver failure from alcoholism.

Serotonin syndrome in depressed patients with migraine

How concerned should clinicians be about serotonin syndrome when prescribing a triptan with a selective serotonin reuptake inhibitor (SSRI)?

Is there one pill to treat hypertension and migraine?

A hypertensive patient with migraines experienced undesirable side effects (irritability and weight gain) while taking the nonselective beta-blockers nadolol (Corgard) and propranolol (Inderal).

What causes delirium?

Is it possible to have a geriatric patient in serious delirium while all labs and urinalysis are within normal limits?

Advice for managing insomnia in patients with dementia

Experts are not certain why reversed sleep-wake cycles occur in patients with dementia, but it may be related to late-day confusion, end-of-day exhaustion and reduced lighting, among other factors.

Is a patient in pain or seeking drugs?

How should a clinician treat a patient with recurring migraines, that also has a history of drug seeking behavior?

Can acetylcholinesterase inhibitors help students cram?

The acetylcholinesterase inhibitors have produced excellent results in patients with Alzheimer's disease or dementia, but are they also beneficial for students preparing for exams?

Psuedoseizure dilemma

Clinician seeks advice on handling a patient with dramatic psuedoseizures that are provoked by nontoxic environmental stimuli.

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