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In neurologic illness, depression contributes significantly to impairments in quality of life, independent of the severity of the disease. In the evolution of neurodegenerative disorders, depression may predate neurologic signs and symptoms, and there is some evidence that depressive illness itself may be a risk factor in some dementias. Data on th...
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... strategy to treatment should be multidimensional, and individualized to the patient, including; education about the mood disturbance, facilitation of skills to improve strategies to cope with mood symptoms, medications as appropriate, and effective support. In clinical practice, it is well known that all traditional antidepressants studied in PD have been found to be safe and well tolerated; efficacy, relative to placebo, has been demonstrated for nortriptyline, venlafaxine extended release, desipramine, citalopram, and paroxetine, although the time course of the antidepressant response has differed (Table 2). Nortriptyline effectiveness has been observed after eight weeks (49), and both nortriptyline and paroxetine demonstrated longterm maintenance (i.e., six months) of treatment gains (50). ...Similar publications
Epilepsy is a common neurological disease that uses electroencephalogram (EEG) data for its detection purpose. Neurologists make the diagnosis by visual inspection of EEG reports. As it is time-consuming and due to the shortage of specialists worldwide, researchers have proposed automated systems to detect the disease. In the past decade, most of t...
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... Leads and electrodes are parts of a stimulator system that are inserted into the spinal epidural space (for spinal cord stimulators) and the brain (for deep brain stimulators) as shown in Figure 1-3. [28][29][30] The generator, which is positioned in the abdomen for spinal cord stimulators or the subcutaneous tissue of the chest for deep brain stimulators, is connected to the leads and electrodes by wires. The term "pocket infection" refers to the 31-85% of cases where infections happen at the generator pocket; nevertheless, wires (15%-69%) may also be affected. ...
... DBS stands for deep brain stimulation; rTMS stands for repetitive transcranial magnetic stimulation; and tDCS stands for transcranial direct current stimulation. 29 F I G U R E 3 Diagrammatic representation of the primary cortico-basal ganglia-thalamocortical circuits in the human brain. A pseudoanatomical layout of the motor, associative, and limbic circuits is depicted in this picture. ...
As neurosurgery has advanced technologically, more and more neurosurgical implants are being employed on an aging patient population with several comorbidities. As a result, there is a steady increase in the frequency of infections linked to neurosurgical implants, which causes serious morbidity and mortality as well as abnormalities of the skull and inadequate brain protection. We discuss infections linked to internal and external ventricular and lumbar cerebrospinal fluid drainages, neurostimulators, craniotomies, and cranioplasty in this article. Biofilms, which are challenging to remove, are involved in all implant‐associated illnesses. It takes a small quantity of microorganisms to create a biofilm on the implant surface. Skin flora bacteria are implicated in the majority of illnesses. Microorganisms that cause disruptions in wound healing make their way to the implant either during or right after surgery. In about two thirds of patients, implant‐associated infections manifest early (within the first month after surgery), whereas the remaining infections present later as a result of low‐grade infections or by direct extension from adjacent infections (per continuitatem) to the implants due to soft tissue damage. Except for ventriculo‐atrial cerebrospinal fluid shunts, neurosurgical implants are rarely infected by the haematogenous route. This research examines established and clinically validated principles that are applicable to a range of surgical specialties using implants to treat biofilm‐associated infections in orthopaedic and trauma cases. Nevertheless, there is little evidence and no evaluation in sizable patient populations to support the success of this extrapolation to neurosurgical patients. An optimal microbiological diagnostic, which includes sonicating removed implants and extending culture incubation times, is necessary for a positive result. Additionally, a strategy combining surgical and antibiotic therapy is needed. Surgical procedures involve a suitable debridement along with implant replacement or exchange, contingent on the biofilm's age and the state of the soft tissue. A protracted biofilm‐active therapy is a component of antimicrobial treatment, usually lasting 4–12 weeks. This idea is appealing because it allows implants to be changed or kept in place for a single surgical procedure in a subset of patients. This not only enhances quality of life but also lowers morbidity because each additional neurosurgical procedure increases the risk of secondary complications like intracerebral bleeding or ischemia.
In the cases of majority of neurological diseases the symptoms of depression have significant influence on the worsening of the quality of patient’s life, regardless of the severity of the neurological disorders. In the most of neurodegenerative diseases the symptoms of depression often precede the appearance of neurological symptoms. Within recent years, numerous studies have been published demonstrating that disorders of depressive spectrum can be considered as a predictor of some types of dementia. Existing data regarding the methods of therapeutic intervention for depression in the clinical practice are rather scarce, scattered and often based on the «personal experience» of neurologists and psychiatrists. In some patients the diagnostics of depression in the context of neurological disorders can be difficult due to the difficulties in the establishing the contact with the patient as well as cognitive deviations related to neurological disorders. In order to facilitate this task, the effective screening diagnostic methods have been developed for the diagnosis of depression in the context of neurological diseases. The results of clinical studies performed within recent years confirm the important role of the neurologist for the evaluation and the treatment of the symptoms of depression, both at the initial stage and at the stage of remission. The purpose of the current review is to systematize the accumulated data on the disorders of depressive spectrum in the context of neurological practice, as well as to demonstrate the role of neurologist in the process of diagnosis and treatment of the symptoms of depression in neurological diseases.
