Family Practice Issues in Neurology
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Fall 1999
Volume 10, Number 2
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 Contents
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From the Guest Editor
Kenton I. Voorhees, MD
Medical Director, Swedish Family Medicine Residency
Movement Disorders for the Primary Care Physician
Christopher
F. O’Brien, MD
The complex diagnostic process for movement disorders is essentially
one of phenomenology first, neurologic examination second, and any
supportive laboratory testing last. In this brief article, an approach to
diagnosis and treatment is outlined for the primary care physician. More
detailed information is available from the recommended references and
resource materials at the end of the article.
Excessive Sleepiness: Diagnosis and Management
Ronald E.
Kramer, MD
Excessive daytime sleepiness, or hypersomnia, accounts for a
substantial percentage of patients with sleep complaints. Basic medical
evaluation, coupled with analysis of a patient’s sleep pattern and
supplemented by sleep laboratory testing, usually is helpful in arriving
at a specific diagnosis, and treatment plan. Sleep timing and circadian
disorders; obstructive sleep apnea; narcolepsy; and periodic limb movement
disorders are the more common causes of excessive daytime sleepiness.
Common Causes of Dizziness
David C. Kelsall, MD
Dizziness is a very common complaint and is often difficult to
evaluate. By using a systemic history, the dizziness can be classified
into vertigo, presyncope, dysequilibrium, and lightheadedness. This
classification significantly narrows the differential diagnosis, helps
target the affected organ system, and can help define the appropriate
specialist referral for persistent cases. In some patients, the etiology
cannot be determined, but it is important to rule out significant
pathology.
Update on Dementia: Evaluation and Treatment
Allen C. Bowling,
MD
Recently, our understanding and treatment of Alzheimer’s disease and
other dementias have improved. Studies have identified new risk factors
and possible pathologic processes involved in Alzheimer’s disease. In
addition, therapy is available that may improve cognition and slow disease
progression in patients with Alzheimer’s disease. This article reviews
the current understanding of Alzheimer’s disease and other dementias and
emphasizes the importance of early diagnosis and early treatment.
Brain Attack: A Personal Reflection
Don B. Smith, MD
This is a refreshing article using a unique style of personal
reflection to shed insight into how new technological advances in medicine
take place.
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