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Abdominal Wall Pain: Clinical Evaluation, Differential Diagnosis, and Treatment - ...

Oct 1, 2018 - Abdominal wall pain is often mistaken for intra-abdominal visceral pain, resulting in expensive and unnecessary laboratory tests, imaging studies, consultations, and invasive procedures. Those evaluations generally are nondiagnostic, and lingering pain can become frustrating to the ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1001/p429.html

Dizziness: Approach to Evaluation and Management - American Family Physician

Feb 1, 2017 - Dizziness is a common yet imprecise symptom. It was traditionally divided into four categories based on the patient’s history: vertigo, presyncope, disequilibrium, and light-headedness. However, the distinction between these symptoms is of limited clinical usefulness. Patients have ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p154.html

Migraine Headache Prophylaxis - American Family Physician

Jan 1, 2019 - Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p17.html

Mechanical Low Back Pain - American Family Physician

Oct 1, 2018 - Low back pain is usually nonspecific or mechanical. Mechanical low back pain arises intrinsically from the spine, intervertebral disks, or surrounding soft tissues. Clinical clues, or red flags, may help identify cases of nonmechanical low back pain and prompt further evaluation or ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1001/p421.html

Acute Migraine Headache: Treatment Strategies - American Family Physician

Feb 15, 2018 - Migraine is a primary headache disorder characterized by recurrent attacks. Acetaminophen, nonsteroidal anti-inflammatory drugs, triptans, antiemetics, ergot alkaloids, and combination analgesics have evidence supporting their effectiveness in the treatment of migraine. Acetaminophen ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p243.html

Headache - American Family Physician

Jun 15, 2019 - This collection features AFP content on headaches and related issues, including cluster headaches, migraines, tension-type headaches, and treatment of headaches. This collection features AFP content on headaches and related issues, including cluster headaches, migraines, tension-type ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=10

Current Concepts in Concussion: Initial Evaluation and Management - American Family ...

Apr 1, 2019 - Mild traumatic brain injury, also known as concussion, is common in adults and youth and is a major health concern. Concussion is caused by direct or indirect external trauma to the head resulting in shear stress to brain tissue from rotational or angular forces. Concussion can affect a...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p426.html

Dementia - American Family Physician

Sep 15, 2019 - This collection features AFP content on dementia and related issues, including Alzheimer’s, Binswanger’s type, dementia, and dementia with Lewy bodies. This collection features AFP content on dementia and related issues, including Alzheimer’s, Binswanger’s type, dementia, and dementia ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=5

Nonoperative Management of Cervical Radiculopathy - American Family Physician

May 1, 2016 - Cervical radiculopathy describes pain in one or both of the upper extremities, often in the setting of neck pain, secondary to compression or irritation of nerve roots in the cervical spine. It can be accompanied by motor, sensory, or reflex deficits and is most prevalent in persons 50 ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0501/p746.html

Herpes Zoster and Postherpetic Neuralgia: Prevention and Management - American Family ...

Nov 15, 2017 - Herpes zoster, or shingles, is caused by reactivation of varicella zoster virus, which causes chickenpox. There are an estimated 1 million cases in the Unites States annually, with an individual lifetime risk of 30%. Patients with conditions that decrease cell-mediated immunity are 20 ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1115/p656.html

Evaluation of Suspected Dementia - American Family Physician

Mar 15, 2018 - Dementia is a significant and costly health condition that affects 5 million adults and is the fifth leading cause of death among Americans older than 65 years. The prevalence of dementia will likely increase in the future because the number of Americans older than 65 years is expected ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p398.html

Stroke and TIA - American Family Physician

Sep 15, 2019 - This collection features AFP content on stroke and related issues, including acute ischemic stroke, statins, and transient ischemic attacks. This collection features AFP content on stroke and related issues, including acute ischemic stroke, statins, and transient ischemic attacks.

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=24

Pain: Chronic - American Family Physician

Dec 1, 2019 - This collection features AFP content on chronic pain and related issues, including end-of-life care, NSAIDs, and opioid therapy. This collection features AFP content on chronic pain and related issues, including end-of-life care, NSAIDs, and opioid therapy.

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=61

Recurrent Abdominal Pain in Children - American Family Physician

Jun 15, 2018 - Recurrent abdominal pain (RAP) in children is defined as at least three episodes of pain that occur over at least three months and affect the child’s ability to perform normal activities. RAP is most often considered functional (nonorganic) abdominal pain, but an organic cause is found ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0615/p785.html

Evaluation and Management of Orthostatic Hypotension - American Family Physician

Sep 1, 2011 - Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position. It results from an inadequate physiologic...

American Family Physician : Article

https://www.aafp.org/afp/2011/0901/p527.html

Febrile Seizures: Risks, Evaluation, and Prognosis - American Family Physician

Apr 1, 2019 - A febrile seizure is a seizure occurring in a child six months to five years of age that is accompanied by a fever (100.4°F or greater) without central nervous system infection. Febrile seizures are classified as simple or complex. A complex seizure lasts 15 minutes or more, is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p445.html

Neuropsychological Evaluations in Adults - American Family Physician

Jan 15, 2019 - Neuropsychologists provide detailed assessments of cognitive and emotional functioning that often cannot be obtained through other diagnostic means. They use standardized assessment tools and integrate the findings with other data to determine whether cognitive decline has occurred, to ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0115/p101.html

Tremor: Sorting Through the Differential Diagnosis - American Family Physician

Feb 1, 2018 - Tremor is an involuntary, rhythmic, oscillatory movement of a body part. It is the most common movement disorder encountered in primary care. The diagnosis of tremor is based on clinical information obtained from the history and physical examination. The most common tremors in patients ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0201/p180.html

Ear and Hearing Disorders - American Family Physician

Sep 15, 2019 - This collection features AFP content on ear and hearing disorders and related issues, including hearing loss, otitis externa, otitis media, and tinnitus. This collection features AFP content on ear and hearing disorders and related issues, including hearing loss, otitis ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=98

Recurrent Ischemic Stroke: Strategies for Prevention - American Family Physician

Oct 1, 2017 - Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p436.html

Seizure Disorders - American Family Physician

Apr 1, 2019 - This collection features AFP content on seizure disorders, including antiepileptic medications, epilepsy, febrile seizures, nonepileptic seizures, seizures in the elderly, and status epilepticus. This collection features AFP content on seizure disorders, including antiepileptic ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=80

Manipulative Therapies: What Works - American Family Physician

Feb 15, 2019 - Manipulative therapies include osteopathic manipulative treatment and many other forms of manual therapies used to manage a variety of conditions in adults and children. Spinal manipulative therapy may provide short-term improvement in patients with acute or chronic low back pain, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p248.html

Recognition and Management of Motor Delay and Muscle Weakness in Children - American ...

Jan 1, 2015 - Diagnosis of neuromuscular disorders in young children is often delayed for years after symptoms emerge, resulting in missed opportunities for therapy and genetic counseling. Identification of the weak child begins with careful attention to caregiver concerns and developmental ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0101/p38.html

Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and ...

Jun 15, 2017 - Alzheimer disease comprises a syndrome of progressive cognitive and functional decline. Treatments should target cognitive and functional symptoms. Cholinesterase inhibitors, memantine, and a combination of a cholinesterase inhibitor and memantine have produced statistically significant...

American Family Physician : Article

https://www.aafp.org/afp/2017/0615/p771.html

Approach to Acute Headache in Adults - American Family Physician

May 15, 2013 - Approximately one-half of the adult population worldwide is affected by a headache disorder. The International Headache Society classification and diagnostic criteria can help physicians differentiate primary headaches (e.g., tension, migraine, cluster) from secondary headaches (e.g., ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0515/p682.html

Delirium in Older Persons: Evaluation and Management - American Family Physician

Aug 1, 2014 - Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition. It is common in older persons in the hospital and long-term care facilities and may indicate a life-threatening condition. Assessment for and prevention of delirium should occur at ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0801/p150.html

Gait and Balance Disorders in Older Adults - American Family Physician

Jul 1, 2010 - Gait and balance disorders are common in older adults and are a major cause of falls in this population. They are associated with increased morbidity and mortality, as well as reduced level of function. Common causes include arthritis and orthostatic hypotension; however, most gait and ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0701/p61.html

Epilepsy: Treatment Options - American Family Physician

Jul 15, 2017 - The occurrence of a single seizure does not always require initiation of antiepileptic drugs. Risk of recurrent seizures should guide their use. In adults, key risk factors for recurrence are two unprovoked seizures occurring more than 24 hours apart, epileptiform abnormalities on ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0715/p87.html

Prevention and Treatment of Motion Sickness - American Family Physician

Jul 1, 2014 - Motion sickness is a common syndrome that occurs upon exposure to certain types of motion. It is thought to be caused by conflict between the vestibular, visual, and other proprioceptive systems. Although nausea is the hallmark symptom, it is often preceded by stomach awareness, ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p41.html

Cervical Radiculopathy: Nonoperative Management of Neck Pain and Radicular Symptoms - ...

Jan 1, 2010 - Cervical radiculopathy is a disease process marked by nerve compression from herniated disk material or arthritic bone spurs. This impingement typically produces neck and radiating arm pain or numbness, sensory deficits, or motor dysfunction in the neck and upper extremities. Magnetic ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0101/p33.html

Charcot Foot: Clinical Clues, Diagnostic Strategies, and Treatment Principles - ...

May 1, 2018 - Acute Charcot neuroarthropathy of the foot and ankle is often difficult to diagnose because of limited findings in the patient history, physical examination, imaging, and laboratory studies. Delay in treatment results in the development of rigid foot and ankle deformities, increasing ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0501/p594.html

Treating Painful Diabetic Peripheral Neuropathy: An Update - American Family Physician

Aug 1, 2016 - Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p227.html

Peripheral Nerve Entrapment and Injury in the Upper Extremity - American Family Physician

Jan 15, 2010 - Peripheral nerve injury of the upper extremity commonly occurs in patients who participate in recreational (e.g., sports) and occupational activities. Nerve injury should be considered when a patient experiences pain, weakness, or paresthesias in the absence of a known bone, soft ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0115/p147.html

Dizziness: A Diagnostic Approach - American Family Physician

Aug 15, 2010 - Dizziness accounts for an estimated 5 percent of primary care clinic visits. The patient history can generally classify dizziness into one of four categories: vertigo, disequilibrium, presyncope, or lightheadedness. The main causes of vertigo are benign paroxysmal positional vertigo, ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0815/p361.html

Diagnosis of Acute Stroke - American Family Physician

Apr 15, 2015 - Stroke can be categorized as ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Awakening with or experiencing the abrupt onset of focal neurologic deficits is the hallmark of the diagnosis of ischemic stroke. The most common presenting symptoms of ischemic stroke ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0415/p528.html

Primary Brain Tumors in Adults: Diagnosis and Treatment - American Family Physician

Feb 1, 2016 - Primary intracranial tumors of the brain structures, including meninges, are rare with an overall five-year survival rate of 33.4%; they are collectively called primary brain tumors. Proven risk factors for these tumors include certain genetic syndromes and exposure to high-dose ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0201/p211.html

Treatment of Acute Migraine Headache - American Family Physician

Feb 1, 2011 - Migraine headache is a common and potentially debilitating disorder often treated by family physicians. Before diagnosing migraine, serious intracranial pathology must be ruled out. Treating acute migraine is challenging because of substantial rates of nonresponse to medications and ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0201/p271.html

Peripheral Neuropathy: Differential Diagnosis and Management - American Family Physician

Apr 1, 2010 - Peripheral neuropathy has a variety of systemic, metabolic, and toxic causes. The most common treatable causes include diabetes mellitus, hypothyroidism, and nutritional deficiencies. The diagnosis requires careful clinical assessment, judicious laboratory testing, and electrodiagnostic...

American Family Physician : Article

https://www.aafp.org/afp/2010/0401/p887.html

Update on Vitamin B12 Deficiency - American Family Physician

Jun 15, 2011 - Vitamin B12 (cobalamin) deficiency is a common cause of megaloblastic anemia, a variety of neuropsychiatric symp- toms, and elevated serum homocysteine levels, especially in older persons. There are a number of risk factors for vitamin B12 deficiency, including prolonged use of ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0615/p1425.html

Pharmacologic Therapy for Acute Pain - American Family Physician

Jun 1, 2013 - The approach to patients with acute pain begins by identifying the underlying cause and a disease-specific treatment. The first-line pharmacologic agent for the symptomatic treatment of mild to moderate pain is acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID). The choice ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0601/p766.html

Differentiation and Diagnosis of Tremor - American Family Physician

Mar 15, 2011 - Tremor, an involuntary, rhythmic, oscillatory movement of a body part, is the most common movement disorder encountered in clinical practice. Rest tremors occur in a body part that is relaxed and completely supported against gravity. Action tremors occur with voluntary contraction of a ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0315/p697.html

Weighing the Risks and Benefits of Chronic Opioid Therapy - American Family Physician

Jun 15, 2016 - Evidence supports the use of opioids for treating acute pain. However, the evidence is limited for the use of chronic opioid therapy for chronic pain. Furthermore, the risks of chronic therapy are significant and may outweigh any potential benefits. When considering chronic opioid ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0615/p982.html

Pituitary Adenomas: An Overview - American Family Physician

Sep 1, 2013 - Prolactinomas and nonfunctioning adenomas are the most common types of pituitary adenomas. Patients with pituitary adenomas may present initially with symptoms of endocrine dysfunction such as infertility, decreased libido, and galactorrhea, or with neurologic symptoms such as headache ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0901/p319.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

Chronic Daily Headache: Diagnosis and Management - American Family Physician

Apr 15, 2014 - Chronic daily headache is defined as the presence of a headache on 15 days or more per month for at least three months. The most common types of chronic daily headache are chronic migraines and chronic tension-type headaches. If a red flag for a secondary cause of headache is present, ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0415/p642.html

Pharmacologic Management of Pain at the End of Life - American Family Physician

Jul 1, 2014 - Although many patients experience debilitating pain at the end of life, there are many options to improve analgesia and quality of life. Pain assessment using a validated tool, with attention to patient function and specific goals, helps tailor individual treatment plans. The World ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p26.html

Cluster Headache - American Family Physician

Jul 15, 2013 - Cluster headache causes severe unilateral temporal or periorbital pain, lasting 15 to 180 minutes and accompanied by autonomic symptoms in the nose, eyes, and face. Headaches often recur at the same time each day during the cluster period, which can last for weeks to months. Some ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0715/p122.html

Guillain-Barre Syndrome - American Family Physician

Feb 1, 2013 - Guillain-Barré syndrome consists of a group of neuropathic conditions characterized by progressive weakness and diminished or absent myotatic reflexes. The estimated annual incidence in the United States is 1.65 to 1.79 per 100,000 persons. Guillain-Barré syndrome is believed to result ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0201/p191.html

Gabapentinoids for Pain: Potential Unintended Consequences - Editorials - American ...

Dec 1, 2019 - The widespread and often indiscriminate prescribing of gabapentinoids is not supported by robust evidence, and it carries known and unknown risks.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1201/p672.html

Multiple Sclerosis: A Primary Care Perspective - American Family Physician

Nov 1, 2014 - Multiple sclerosis (MS) is the most common permanently disabling disorder of the central nervous system in young adults. Relapsing remitting MS is the most common type, and typical symptoms include sensory disturbances, Lhermitte sign, motor weakness, optic neuritis, impaired ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1101/p644.html

Bell's Palsy: Diagnosis and Management - American Family Physician

Oct 1, 2007 - Bell's palsy is a peripheral palsy of the facial nerve that results in muscle weakness on one side of the face. Affected patients develop unilateral facial paralysis over one to three days with forehead involvement and no other neurologic abnormalities. Symptoms typically peak in the ...

American Family Physician : Article

https://www.aafp.org/afp/2007/1001/p997.html

Evaluation of Syncope - American Family Physician

Sep 15, 2011 - Syncope is a transient and abrupt loss of consciousness with complete return to preexisting neurologic function. It is classified as neurally mediated (i.e., carotid sinus hypersensitivity, situational, or vasovagal), cardiac, orthostatic, or neurogenic. Older adults are more likely to ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0915/p640.html

Infiltrative Anesthesia in Office Practice - American Family Physician

Jun 15, 2014 - When choosing an infiltrative anesthetic agent, the type of procedure, the length of time required for anesthesia, and the pharmacodynamics of each medication are important considerations. Distraction techniques and buffering with sodium bicarbonate can be used to decrease the pain ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0615/p956.html

Transient Ischemic Attack: Part I. Diagnosis and Evaluation - American Family Physician

Sep 15, 2012 - Transient ischemic attack is defined as transient neurologic symptoms without evidence of acute infarction. It is a common and important risk factor for future stroke, but is greatly underreported. Common symptoms are sudden and transient, and include unilateral paresis, speech ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0915/p521.html

Common Questions About Bell Palsy - American Family Physician

Feb 1, 2014 - Bell palsy is an acute affliction of the facial nerve, resulting in sudden paralysis or weakness of the muscles on one side of the face. Testing patients with unilateral facial paralysis for diabetes mellitus or Lyme disease is not routinely recommended. Patients with Lyme disease ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0201/p209.html

Recognition and Evaluation of Nontraumatic Subarachnoid Hemorrhage and Ruptured ...

Oct 1, 2013 - Swift diagnosis and treatment are critical for good outcomes in patients with nontraumatic subarachnoid hemorrhage, which is usually caused by a ruptured aneurysm. This type of stroke often results in death or disability. Rates of misdiagnosis and treatment delays for subarachnoid ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1001/p451.html

Evaluation of Suspected Dementia - American Family Physician

Oct 15, 2011 - As the proportion of persons in the United States older than 65 years increases, the prevalence of dementia will increase as well. Risk factors for dementia include age, family history of dementia, apolipoprotein E4 genotype, cardiovascular comorbidities, chronic anticholinergic use, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1015/p895.html

Current Concepts in Concussion: Evaluation and Management - American Family Physician

Jan 15, 2012 - Concussion is a disturbance in brain function caused by direct or indirect force to the head. It is a functional rather than structural injury that results from shear stress to brain tissue caused by rotational or angular forces—direct impact to the head is not required. Initial ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0115/p123.html

Subacute Management of Ischemic Stroke - American Family Physician

Dec 15, 2011 - Ischemic stroke is the third leading cause of death in the United States and a common reason for hospitalization. The subacute period after a stroke refers to the time when the decision to not employ thrombolytics is made up until two weeks after the stroke occurred. Family physicians ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1215/p1383.html

Parkinson Disease: An Update - American Family Physician

Feb 15, 2013 - Parkinson disease is a progressive neurologic disorder afflicting approximately 1 percent of Americans older than 60 years. The cardinal features of Parkinson disease are bradykinesia, rigidity, tremor, and postural instability. There are a number of neurologic conditions that mimic the...

American Family Physician : Article

https://www.aafp.org/afp/2013/0215/p267.html

Febrile Seizures: Risks, Evaluation, and Prognosis - American Family Physician

Jan 15, 2012 - Febrile seizures are common in the first five years of life, and many factors that increase seizure risk have been identified. Initial evaluation should determine whether features of a complex seizure are present and identify the source of fever. Routine blood tests, neuroimaging, and ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0115/p149.html

Evaluation of First Nonfebrile Seizures - American Family Physician

Aug 15, 2012 - Nonfebrile seizures may indicate underlying disease or epilepsy. The patient history can often distinguish epileptic seizures from nonepileptic disorders by identifying the events directly preceding the convulsion, associated conditions, and details of the seizure, including triggers, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0815/p334.html

Herpes Zoster and Postherpetic Neuralgia: Prevention and Management - American Family ...

Jun 15, 2011 - Herpes zoster (shingles) is diagnosed clinically by recognition of the distinctive, painful vesicular rash appearing in a unilateral, dermatomal distribution. An estimated 1 million cases occur in the United States each year, and increasing age is the primary risk factor. Laboratory ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0615/p1432.html

Transient Ischemic Attack: Part II. Risk Factor Modification and Treatment - American ...

Sep 15, 2012 - Interventions following a transient ischemic attack are aimed at preventing a future episode or stroke. Hypertension, current smoking, obesity, physical inactivity, diabetes mellitus, and dyslipidemia are all well-known risk factors, and controlling these factors can have dramatic ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0915/p527.html

Subacute to Chronic Mild Traumatic Brain Injury - American Family Physician

Dec 1, 2012 - Although a universally accepted definition is lacking, mild traumatic brain injury and concussion are classified by transient loss of consciousness, amnesia, altered mental status, a Glasgow Coma Score of 13 to 15, and focal neurologic deficits following an acute closed head injury. ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1201/p1045.html

Treatment of Vertigo - American Family Physician

Mar 15, 2005 - Vertigo is the illusion of motion, usually rotational motion. As patients age, vertigo becomes an increasingly common presenting complaint. The most common causes of this condition are benign paroxysmal positional vertigo, acute vestibular neuronitis or labyrinthitis, Ménière's ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0315/p1115.html

Medications for Migraine Prophylaxis - American Family Physician

Jan 1, 2006 - Sufficient evidence and consensus exist to recommend propranolol, timolol, amitriptyline, divalproex, sodium valproate, and topiramate as first-line agents for migraine prevention. There is fair evidence of effectiveness with gabapentin and naproxen sodium. Botulinum toxin also has ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0101/p72.html

Treatment of Alzheimer Disease - American Family Physician

Jun 15, 2011 - Alzheimer disease is the most common form of dementia, affecting more than one-third of Americans older than 85 years. It is characterized by progressive memory loss and cognitive decline. Amyloid plaque accumulation, neurofibrillary tau tangles, and depletion of acetylcholine are among...

American Family Physician : Article

https://www.aafp.org/afp/2011/0615/p1403.html

Chronic Low Back Pain: Evaluation and Management - American Family Physician

Jun 15, 2009 - Chronic low back pain is a common problem in primary care. A history and physical examination should place patients into one of several categories: (1) nonspecific low back pain; (2) back pain associated with radiculopathy or spinal stenosis; (3) back pain referred from a nonspinal ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0615/p1067.html

Rational Use of Opioids for Management of Chronic Nonterminal Pain - American Family ...

Aug 1, 2012 - Opioid prescribing for chronic nonterminal pain has increased in recent years, although evidence for its long-term effectiveness is weak and its potential for harm is significant. Nonmedical use of prescription opioids, diversion, and overdose deaths have also increased sharply, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0801/p252.html

Cerebrospinal Fluid Analysis - American Family Physician

Sep 15, 2003 - Lumbar puncture is frequently performed in primary care. Properly interpreted tests can make cerebrospinal fluid (CSF) a key tool in the diagnosis of a variety of diseases. Proper evaluation of CSF depends on knowing which tests to order, normal ranges for the patient's age, and the ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0915/p1103.html

Initial Evaluation of Vertigo - American Family Physician

Jan 15, 2006 - Benign paroxysmal positional vertigo, acute vestibular neuronitis, and Meniere's disease cause most cases of vertigo; however, family physicians must consider other causes including cerebrovascular disease, migraine, psychological disease, perilymphatic fistulas, multiple sclerosis, and...

American Family Physician : Article

https://www.aafp.org/afp/2006/0115/p244.html

Evaluation of the Patient with Muscle Weakness - American Family Physician

Apr 1, 2005 - Muscle weakness is a common complaint among patients presenting to family physicians. Diagnosis begins with a patient history distinguishing weakness from fatigue or asthenia, separate conditions with different etiologies that can coexist with, or be confused for, weakness. The pattern ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0401/p1327.html

Dual Antiplatelet Therapy for High-Risk TIA and Minor Stroke: BMJ Rapid Recommendation ...

Sep 15, 2019 - Based on a recent randomized controlled trial followed by a systematic review, the BMJ and MAGIC group concluded that dual antiplatelet therapy use for a limited period after mild stroke is beneficial.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0915/p378.html

Trigeminal Neuralgia - American Family Physician

May 1, 2008 - Trigeminal neuralgia is an uncommon disorder characterized by recurrent attacks of lancinating pain in the trigeminal nerve distribution. Typically, brief attacks are triggered by talking, chewing, teeth brushing, shaving, a light touch, or even a cool breeze. The pain is nearly always ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0501/p1291.html

Treating Diabetic Peripheral Neuropathic Pain - American Family Physician

Jul 15, 2010 - Diabetic peripheral neuropathic pain affects the functionality, mood, and sleep patterns of approximately 10 to 20 percent of patients with diabetes mellitus. Treatment goals include restoring function and improving pain control. Patients can realistically expect a 30 to 50 percent ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0715/p151.html

Behavior Disorders of Dementia: Recognition and Treatment - American Family Physician

Feb 15, 2006 - Psychosis may pose a greater challenge than cognitive decline for patients with dementia and their caregivers. The nature and frequency of psychotic symptoms varies over the course of illness, but in most patients, these symptoms occur more often in the later stages of disease. ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0215/p647.html

Frontotemporal Dementia: A Review for Primary Care Physicians - American Family Physician

Dec 1, 2010 - Frontotemporal dementia (FTD) is one of the most common forms of dementia in persons younger than 65 years. Variants include behavioral variant FTD, semantic dementia, and progressive nonfluent aphasia. Behavioral and language manifestations are core features of FTD, and patients have ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1201/p1372.html

Acute Stroke Diagnosis - American Family Physician

Jul 1, 2009 - Stroke can be categorized as ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. Awakening with or experiencing the abrupt onset of focal neurologic deficits is the hallmark of ischemic stroke diagnosis. The most common presenting symptoms for ischemic stroke are ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0701/p33.html

Primary Brain Tumors in Adults - American Family Physician

May 15, 2008 - Primary malignant brain tumors account for 2 percent of all cancers in U.S. adults. The most common malignant brain tumor is glioblastoma multiforme, and patients with this type of tumor have a poor prognosis. Previous exposure to high-dose ionizing radiation is the only proven ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0515/p1423.html

Diagnosing Dementia and Clarifying Goals of Care - Lown Right Care: Reducing Overuse ...

Sep 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2019/0915/p369.html

Neuropsychological Evaluation in Primary Care - American Family Physician

Sep 1, 2010 - Referring a patient to a neuropsychologist for evaluation provides a level of rigorous assessment of brain function that often cannot be obtained in other ways. The neuropsychologist integrates information from the patient’s medical history, laboratory tests, and imaging studies; an ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0901/p495.html

Ibuprofen Plus Acetaminophen Equals Opioid Plus Acetaminophen for Acute Severe ...

Mar 1, 2018 - In adults presenting to the emergency department with acute extremity pain severe enough to warrant radiologic investigation, ibuprofen plus acetaminophen was equally effective in reducing pain intensity at two hours compared with three different opioid and acetaminophen combination ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0301/p348.html

Erenumab (Aimovig) for Migraine Prophylaxis in Adults - STEPS - American Family Physician

Jun 15, 2019 - Erenumab is a safe option for migraine prophylaxis in adults. However, it is expensive and should be reserved for patients who have experienced intolerable adverse effects while taking oral migraine prophylaxis medication or who have poor adherence to daily preventive treatment.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0615/p781.html

Management of Status Epilepticus - American Family Physician

Aug 1, 2003 - Status epilepticus is an increasingly recognized public health problem in the United States. Status epilepticus is associated with a high mortality rate that is largely contingent on the duration of the condition before initial treatment, the etiology of the condition, and the age of ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0801/p469.html

Chronic Neck Pain: Nonpharmacologic Treatment - Implementing AHRQ Effective Health Care...

Aug 1, 2019 - Which noninvasive nonpharmacologic treatments for chronic neck pain improve function or pain for at least one month?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0801/p180.html

Apixaban (Eliquis) for Stroke Prevention in Atrial Fibrillation - STEPS - American ...

Apr 15, 2014 - Apixaban is at least as effective as aspirin or warfarin for preventing strokes in high-risk patients with nonvalvular atrial fibrillation, especially those who cannot or will not take warfarin. It is slightly less likely to cause major bleeding and may have better compliance because it...

American Family Physician : STEPS

https://www.aafp.org/afp/2014/0415/p672.html

Integrating Medical Acupuncture into Family Medicine Practice - Editorials - American ...

Jul 15, 2019 - Acupuncture is an evidence-based therapy to reduce pain that can meet patient demand for nonpharmacologic treatment. Now is the time to offer training in medical acupuncture to more family physicians.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0715/p76.html

Gabapentin and Pregabalin Not Effective for Low Back Pain with or Without Radiculopathy...

Mar 15, 2019 - The use of anticonvulsants like gabapentin (Neurontin) for painful conditions has increased greatly in recent years. This review finds good evidence that these drugs are not an effective treatment for low back pain with or without radiculopathy, and are associated with an increased risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od2.html

Alternative Interventions for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Men -...

Jun 1, 2019 - In men with chronic pelvic pain and urinary dysfunction who have not responded to standard medical management, extracorporeal shock wave therapy reduces symptoms and increases quality of life. Acupuncture may also provide benefit to some patients.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0601/p677.html

Short-Term Clopidogrel Plus Aspirin Prevents Second Ischemic Stroke Better Than Aspirin...

Aug 15, 2019 - Combined treatment with clopidogrel and aspirin, started within 24 hours of the first event, will decrease the likelihood of a recurrent stroke in an additional 2% of patients compared with aspirin alone, with a slight increase in the risk of extra-cranial bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249.html

Acute Lumbar Disk Pain: Navigating Evaluation and Treatment Choices - American Family ...

Oct 1, 2008 - Acute lumbar disk herniations are the most common cause of sciatica. After excluding emergent causes, such as cauda equina syndrome, epidural abscess, fracture, or malignancy, a six-week trial of conservative management is indicated. Patients should be advised to stay active. If ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1001/p835.html

Vitamin D is Equal to Placebo for Preventing Cognitive Decline in African-American ...

Jul 15, 2019 - Is vitamin D more effective than placebo in preventing cognitive decline in African American women older than 65 years who have low serum vitamin D levels at baseline?

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118.html

Vitamin B12 Deficiency - American Family Physician

Mar 1, 2003 - Vitamin B12 (cobalamin) deficiency is a common cause of macrocytic anemia and has been implicated in a spectrum of neuropsychiatric disorders. The role of B12 deficiency in hyperhomocysteinemia and the promotion of atherosclerosis is only now being explored. Diagnosis of vitamin B12 ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0301/p979.html

Mild TBI in Children: Guidance from the CDC for Diagnosis and Treatment - Practice ...

Apr 1, 2019 - Mild traumatic brain injury in children is a major problem in the United States. Based on a systematic literature review, the Centers for Disease Control and Prevention (CDC) released recommendations specific to children with Glasgow Coma Scale scores of 13 to 15.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0401/p462.html

Pharmacologic Interventions for Apathy in Patients with Alzheimer Disease - Cochrane ...

Jan 1, 2019 - Methylphenidate may improve apathy in select patients with AD (mean difference [MD] = –4.99 on the apathy evaluation scale; 95% confidence interval [CI], –9.55 to –0.43), although the clinical significance associated with these findings remains unclear and the evidence is considered low...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0101/p14.html

Sialorrhea--A Management Challenge - American Family Physician

Jun 1, 2004 - Sialorrhea (drooling or excessive salivation) is a common problem in neurologically impaired children (i.e., those with mental retardation or cerebral palsy) and in adults who have Parkinson's disease or have had a stroke. It is most commonly caused by poor oral and facial muscle ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0601/p2628.html

Management of Herpes Zoster (Shingles) and Postherpetic Neuralgia - American Family ...

Apr 15, 2000 - Herpes zoster (commonly referred to as

American Family Physician : Article

https://www.aafp.org/afp/2000/0415/p2437.html

Evaluation of a First Seizure - American Family Physician

May 1, 2007 - Seizure is a common presentation in the emergency care setting, and new-onset epilepsy is the most common cause of unprovoked seizures. The patient history and physical examination should direct the type and timing of laboratory and imaging studies. No single sign, symptom, or test ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0501/p1342.html

Chronic Nonmalignant Pain in Primary Care - American Family Physician

Nov 15, 2008 - A systematic approach to chronic nonmalignant pain includes a comprehensive evaluation; a treatment plan determined by the diagnosis and mechanisms underlying the pain; patient education; and realistic goal setting. The main goal of treatment is to improve quality of life while ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1115/p1155.html

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