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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

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

Frequent Headaches: Evaluation and Management - American Family Physician

Apr 1, 2020 - Most frequent headaches are typically migraine or tension-type headaches and are often exacerbated by medication overuse. Repeated headaches can induce central sensitization and transformation to chronic headaches that are intractable, are difficult to treat, and cause significant ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0401/p419.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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Initial Evaluation of the Patient with Suspected Dementia - American Family Physician

May 1, 2005 - Dementia is a common disorder among older persons, and projections indicate that the number of patients with dementia in the United States will continue to grow. Alzheimer's disease and vascular dementia account for the majority of cases of dementia. After a thorough history and ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0501/p1745.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

Restless Legs Syndrome - American Family Physician

Jul 15, 2008 - Restless legs syndrome is a common neurologic movement disorder that affects approximately 10 percent of adults. Of those affected with this condition, approximately one third have symptoms severe enough to require medical therapy. Restless legs syndrome may be a primary condition, or ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0715/p235.html

Tourette's Syndrome - American Family Physician

Mar 1, 2008 - Tourette's syndrome is a movement disorder most commonly seen in school-age children. The incidence peaks around preadolescence with one half of cases resolving in early adulthood. Tourette's syndrome is the most common cause of tics, which are involuntary or semivoluntary, sudden, ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0301/p651.html

Older Adult Drivers with Cognitive Impairment - American Family Physician

Mar 15, 2006 - As the number of drivers with cognitive impairment increases, family physicians are more likely to become involved in decisions about cessation of driving privileges in older patients. Physicians who care for cognitively impaired older adults should routinely ask about driving status. ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0315/p1029.html

The Patient with Daily Headaches - American Family Physician

Dec 15, 2004 - The term 'chronic daily headache' (CDH) describes a variety of headache types, of which chronic migraine is the most common. Daily headaches often are disabling and may be challenging to diagnose and treat. Medication overuse, or drug rebound headache, is the most treatable cause of ...

American Family Physician : Article

https://www.aafp.org/afp/2004/1215/p2299.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

Dementia With Lewy Bodies: An Emerging Disease - American Family Physician

Apr 1, 2006 - Dementia with Lewy bodies appears to be the second most common form of dementia, accounting for about one in five cases. The condition is characterized by dementia accompanied by delirium, visual hallucinations, and parkinsonism. Other common symptoms include syncope, falls, sleep ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0401/p1223.html

Management of Cluster Headache - American Family Physician

Feb 15, 2005 - Cluster headache, an excruciating, unilateral headache usually accompanied by conjunctival injection and lacrimation, can occur episodically or chronically, and can be difficult to treat. Existing effective treatments may be underused because of underdiagnosis of the syndrome. Oxygen ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0215/p717.html

Cerebral Palsy: An Overview - American Family Physician

Jan 1, 2006 - The presentation of cerebral palsy can be global mental and physical dysfunction or isolated disturbances in gait, cognition, growth, or sensation. It is the most common childhood physical disability and affects 2 to 2.5 children per 1,000 born in the United States. The differential ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0101/p91.html

Oral Analgesics for Acute Nonspecific Pain - American Family Physician

Mar 1, 2005 - Physicians most often recommend or prescribe oral medication for relief of acute pain. This review of the available evidence supports the use of acetaminophen in doses up to 1,000 mg as the initial choice for mild to moderate acute pain. In some cases, modest improvements in analgesic ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0301/p913.html

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

Sep 15, 2005 - The recognizable appearance and the dermatomal distribution of herpes zoster lesions usually enable a clinical diagnosis to be made easily. Herpes zoster and postherpetic neuralgia occur mainly in older patients. The role of the varicella vaccine in preventing herpes zoster is ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0915/p1075.html

Early Diagnosis of Dementia - American Family Physician

Feb 15, 2001 - Until recently, the most significant issue facing a family physician regarding the diagnosis and treatment of dementia was ruling out delirium and potentially treatable etiologies. However, as more treatment options become available, it will become increasingly important to diagnose ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0215/p703.html

Management of Seizures and Epilepsy - American Family Physician

Apr 1, 1998 - While the evaluation and treatment of patients with seizures or epilepsy is often challenging, modern therapy provides many patients with complete seizure control. After a first seizure, evaluation should focus on excluding an underlying neurologic or medical condition, assessing the ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0401/p1589.html

Tension-Type Headache - American Family Physician

Sep 1, 2002 - Tension-type headache typically causes pain that radiates in a band-like fashion bilaterally from the forehead to the occiput. Pain often radiates to the neck muscles and is described as tightness, pressure, or dull ache. Migraine-type features (unilateral, throbbing pain, nausea, ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0901/p797.html

Pharmacologic Treatment of Alzheimer's Disease: An Update - American Family Physician

Oct 1, 2003 - Alzheimer's disease is characterized by the development of senile plaques and neurofibrillary tangles, which are associated with neuronal destruction, particularly in cholinergic neurons. Drugs that inhibit the degradation of acetylcholine within synapses are the mainstay of therapy. ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1001/p1365.html

Advances in the Treatment of Epilepsy - American Family Physician

Jul 1, 2001 - Significant advances have been made in the diagnosis and treatment of epilepsy over the past decade. With the advent of electroencephalographic video monitoring, physicians are now able to reliably differentiate epilepsy from other conditions that can mimic it, such as pseudoseizures. ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0701/p91.html

Cervical Spondylotic Myelopathy: A Common Cause of Spinal Cord Dysfunction in Older ...

Sep 1, 2000 - Cervical spondylotic myelopathy is the most common cause of spinal cord dysfunction in older persons. The aging process results in degenerative changes in the cervical spine that, in advanced stages, can cause compression of the spinal cord. Symptoms often develop insidiously and are ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0901/p1064.html

Update on Parkinson's Disease - American Family Physician

Apr 15, 1999 - Parkinson's disease is a progressive degenerative disorder of the central nervous system. The hallmark physical signs are tremor, rigidity and bradykinesia. Idiopathic Parkinson's disease is caused by the progressive loss of dopaminergic neurons in the substantia nigra and nigrostriatal...

American Family Physician : Article

https://www.aafp.org/afp/1999/0415/p2155.html

Neurological Complications of Scuba Diving - American Family Physician

Jun 1, 2001 - Recreational scuba diving has become a popular sport in the United States, with almost 9 million certified divers. When severe diving injury occurs, the nervous system is frequently involved. In dive-related barotrauma, compressed or expanding gas within the ears, sinuses and lungs ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0601/p2211.html

Recognition and Management of Tourette's Syndrome and Tic Disorders - American Family ...

Apr 15, 1999 - Tic disorders and Tourette's syndrome are conditions that primary care physicians are likely to encounter. Up to 20 percent of children have at least a transient tic disorder at some point. Once believed to be rare, Tourette's syndrome is now known to be a more common disorder that ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0415/p2263.html

Preventing Stroke in Patients with Transient Ischemic Attacks - American Family Physician

Nov 15, 1999 - Stroke is the third most common overall cause of death and the leading cause of adult disability in the United States. New therapeutic interventions instituted in the period immediately after a stroke have revolutionized the approach to ischemic cerebrovascular disease. Recognition of a...

American Family Physician : Article

https://www.aafp.org/afp/1999/1115/p2329.html

New Concepts In Acute Pain Therapy: Preemptive Analgesia - American Family Physician

May 15, 2001 - Pain, which is often inadequately treated, accompanies the more than 23 million surgical procedures performed each year and may persist long after tissue heals. Preemptive analgesia, an evolving clinical concept, involves the introduction of an analgesic regimen before the onset of ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0515/p1979.html

Stroke: Part I. A Clinical Update on Prevention - American Family Physician

May 1, 1999 - Clinical trials conducted during the past five years have yielded important results that have allowed us to refine our approach to stroke prevention. Treatment of isolated systolic hypertension prevents stroke and is generally well tolerated. New antiplatelet agents (clopidogrel and the...

American Family Physician : Article

https://www.aafp.org/afp/1999/0501/p2475.html

Treatment of Nonmalignant Chronic Pain - American Family Physician

Mar 1, 2000 - Nonmalignant, chronic pain is associated with physical, emotional and financial disability. Recent animal studies have shown that remodeling within the central nervous system causes the physical pathogenesis of chronic pain. This central neural plasticity results in persistent pain ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0301/p1331.html

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