Concise Guide to Neuropsychiatry and Behavioral Neurology, by Jeffrey L. Cummings

By Jeffrey L. Cummings

Regardless of dramatic advances in our knowing of the mind and mind problems, we nonetheless have a lot uncharted territory to discover in neuropsychiatry and behavioral neurology, speedily starting to be disciplines dedicated to knowing the behavioral results of mind disorder and utilizing this data to enhance sufferer care. the second one variation of this well known pocket consultant (part of yank Psychiatric Publishing, Inc.'s Concise publications sequence; it actually matches into the pocket of a lab coat or jacket) is up-to-date all through, that includes new medicines and new diagnostic approaches and standards. just like the first variation, it provides short synopses of the main neuropsychiatric and neurobehavioral syndromes, discusses their medical evaluate, and gives instructions for administration, plus a thesaurus, index, and bibliographies that seek advice from extra large examining. The authors summarize diagnostic and therapy info in easy-to-read tables, together with medical gains, underlying pathophysiology, and treatment plans for the key neuropsychiatric issues. starting with numerous chapters on neuropsychiatric overview equipment, easy neuroanatomic and neurochemical ideas, neuropsychiatric indicators (including unexplained neurological indicators, akin to generalized nervousness, panic, and conversion and dissociative problems) and syndromes (e.g., frontal lobe, aphasia), and the differential prognosis of significant neuropsychiatric problems (e.g., melancholy, mania, psychosis, anxiety), the authors set up next chapters via ailment: -Visual/visuospatial impairment, that's severe to human survival and such a lot critical with right-brain disorder and harm, the place it reasons quite a few neuropsychiatric indicators -Disorders of reminiscence (etiology, anatomy, and exams for issues corresponding to amnesia), epilepsy (especially temporal lobe epilepsy), dementia and delirium (emphasizing the medical standards settling on the various dementias), and move issues (including ParkinsonAs illness and hyperkinetic move issues and tremors) -Stroke (cerebrovascular ailment is likely one of the commonest factors of obtained habit swap in adults) and mind tumors (with linked neuropsychiatric morbidity) -White subject ailments (e.g., a number of sclerosis), with got or hereditary leukoencephalopathies, which are additional categorised pathologically or in accordance with the underlying metabolic abnormality; and head damage (e. g., intracranial hematoma, an infection, epilepsy) and its sequelae (e.g., character and cognitive alterations, melancholy, posttraumatic rigidity affliction) the ultimate bankruptcy covers the newest remedies, akin to neuropsychopharmacology (e.g., antidepressants, antipsychotics, sedative hypnotics, mood-stabilizers, anticonvulsants), electroconvulsive treatment, vagus nerve stimulation, and neurosurgical approaches (i.e., destruction of huge tracts of white subject to and from the frontal lobes). An instantly valuable medical significant other for psychiatrists and geriatric psychiatrists, neurologists, and neuropsychologists either in the U.S. and overseas, this quantity is additionally tremendously useful for college kids and citizens as a result of its huge scope and simply available details.

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The connections from the midbrain nuclei, which are the origin of neurotransmitters so relevant to the regulation of behavior, to the forebrain structures such as the nucleus accumbens are referred to as the mesolimbic system. The orbitofrontal cortex is also included as part of the limbic circuitry. Figure 2–1 outlines the most important structures of the limbic system. The amygdala is related to the control of aggression, to affective tone of incoming sensations, to anxiety, to learning associations between stimuli and reinforcement, to laying down emotional memory, and possibly to psychosis.

Source. ” British Journal of Psychiatry 158:8–17, 1991. Copyright 1991. Used with permission. that extend medially under the basal ganglia to the bed nucleus of the stria terminalis and also posteriorly looping anteriorly, like the fornix (see Figure 2–1) in the stria terminalis. The extended amygdala thus can be conceptualized as a group of interconnected structures that receive rich monoamine input from ascending midbrain afferents; through its efferents, it broadly influences hypothalamic, autonomic, and somatomotor functions.

Depression is treated with psychotherapy, pharmacotherapy, electroconvulsive therapy, and vagus nerve stimulation. Pharmacological agents used to treat depression include selective serotonin reuptake inhibitors, noradrenergic reuptake inhibitors, serotonin/ norepinephrine reuptake inhibitors, and monoamine oxidase inhibitors (see Chapter 15). ■ MANIA The manic syndrome comprises abnormalities of mood, affect, cognition, motor activity, and neurovegetative function. Mood changes Depression occurring in conjunction with neurological disorders Neurological condition Frequency of depressive syndromes (%)a Characteristics of the depressive syndrome Stroke 30–60 Psychomotor retardation often severe; depression more common in patients with brain atrophy, with left frontal and left caudate lesions, and when lesion approaches the left frontal pole Parkinson’s disease 30–50 Anxiety is commonly present; mood-congruent delusions and suicide are rare; PET reveals diminished orbitofrontal and caudate glucose metabolism Huntington’s disease 35–45 Suicide is common; PET reveals diminished orbitofrontal glucose metabolism Epilepsy 10–50 Frequency of suicide and delusions is increased; PET reveals diminished orbitofrontal or left brain glucose metabolism Traumatic brain injury 25–50 A history of psychiatric disorder (including substance abuse) more common among the patients who develop posttraumatic depression Multiple sclerosis 25–50 Depression is not related to the degree of disability Alzheimer’s disease 30–40 Major depressive episodes are rare; depressive symptoms are common Vascular dementia 25–60 Depression is common in lacunar state and Binswanger’s disease Note.

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