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199 PSYCHIATRIC MEDICATIONS

199 PSYCHIATRIC MEDICATIONS Harrison’s Manual of Medicine 199 PSYCHIATRIC MEDICATIONS General Principles of Use Antidepressants Anxiolytics Antipsychotic Medications Mood-Stabilizing Agents Bibliography Four major classes of psychiatric medications are commonly used in adults: (1) antidepressants, (2) anxiolytics, (3) antipsychotics, and (4) mood stabilizing agents. Nonpsychiatric physicians should become familiar with one or two drugs in each […]

198 APPROACH TO THE PATIENT WITH PSYCHIATRIC SYMPTOMS

198 APPROACH TO THE PATIENT WITH PSYCHIATRIC SYMPTOMS Harrison’s Manual of Medicine 198 APPROACH TO THE PATIENT WITH PSYCHIATRIC SYMPTOMS Major Psychiatric Disorders (Axis I Diagnoses) Mood Disorders (Major Affective Disorders) Schizophrenia and Other Psychotic Disorders Anxiety Disorders Personality Disorders (Axis Ii Diagnoses) Cluster A Personality Disorders Cluster B Personality Disorders Cluster C Personality Disorders […]

197 MUSCLE DISEASES Harrison’s Manual of Medicine 197 MUSCLE DISEASES Muscular Dystrophies Duchenne Dystrophy Myotonic Dystrophy Facioscapulohumeral Dystrophy Limb-Girdle Dystrophy Oculopharyngeal Dystrophy (Progressive External Ophthalmoplegia) Inflammatory Myopathies Metabolic Myopathies Mitochondrial Myopathies Periodic Paralyses Miscellaneous Disorders Bibliography Muscle diseases usually present as intermittent or persistent weakness. These disorders are usually painless; however, myalgias, or muscle pains, […]

196 MYASTHENIA GRAVIS (MG)

196 MYASTHENIA GRAVIS (MG) Harrison’s Manual of Medicine 196 MYASTHENIA GRAVIS (MG) Clinical Features Pathophysiology Differential Diagnosis Laboratory Evaluation Bibliography An autoimmune neuromuscular disorder resulting in weakness and fatiguability of skeletal muscles, due to autoantibodies directed against acetylcholine receptors (AChRs) at neuromuscular junctions (NMJs). Clinical Features May present at any age. Symptoms fluctuate throughout the […]

195 PERIPHERAL NEUROPATHIES INCLUDING GUILLAIN-BARRé SYNDROME

195 PERIPHERAL NEUROPATHIES INCLUDING GUILLAIN-BARRé SYNDROME Harrison’s Manual of Medicine 195 PERIPHERAL NEUROPATHIES INCLUDING GUILLAIN-BARRé SYNDROME Polyneuropathy Mononeuropathy Bibliography Peripheral neuropathy (PN) refers to a peripheral nerve disorder of any cause. Nerve involvement may be single (mononeuropathy) or multiple (polyneuropathy); pathology may be axonal or demyelinating. An approach to pts with suspected neuropathy appears in […]

194 SPINAL CORD DISEASES

194 SPINAL CORD DISEASES Harrison’s Manual of Medicine 194 SPINAL CORD DISEASES Symptoms and Signs Specific Signs by Spinal Cord Level Intramedullary and Extramedullary Syndromes Acute and Subacute Spinal Cord Diseases Chronic Myelopathies Complications Bibliography Diseases of the spinal cord can be devastating, but many are treatable if recognized early (Table 194-1). A working knowledge […]

193 AUTONOMIC NERVOUS SYSTEM DISORDERS

193 AUTONOMIC NERVOUS SYSTEM DISORDERS Harrison’s Manual of Medicine 193 AUTONOMIC NERVOUS SYSTEM DISORDERS ANS Overview Disorders of the ANS Bibliography The autonomic nervous system (ANS) regulates homeostatic functions critical to survival including blood pressure, blood flow, tissue perfusion, sweating, hunger, satiety, temperature, thirst, and circadian rhythms. The importance of this regulation is demonstrated by […]

192 CRANIAL NERVE DISORDERS

192 CRANIAL NERVE DISORDERS Harrison’s Manual of Medicine 192 CRANIAL NERVE DISORDERS Olfactory Nerve (I) Trigeminal Nerve (V) Facial Nerve (VII) Glossopharyngeal Nerve (IX) Vagus Nerve (X) Hypoglossal Nerve (XII) Multiple Cranial Nerve Palsies Bibliography Disorders of vision and ocular movement are discussed in Chap. 10 and Chap. 48; dizziness and vertigo in Chap. 9; […]

191 ALS AND OTHER MOTOR NEURON DISEASE

191 ALS AND OTHER MOTOR NEURON DISEASES Harrison’s Manual of Medicine 191 ALS AND OTHER MOTOR NEURON DISEASES Etiology Clinical History Physical Examination Laboratory Findings Complications Bibliography Etiology Amyotrophic lateral sclerosis (ALS) is the most important of the motor neuron diseases (Table 191-1). ALS is caused by degeneration of motor neurons at all levels of […]

190 ATAXIC DISORDERS

190 ATAXIC DISORDERS Harrison’s Manual of Medicine 190 ATAXIC DISORDERS Clinical Presentation Inherited Ataxias Evaluation Bibliography Clinical Presentation Symptoms and signs of ataxia may include gait instability, nystagmus, dysarthria (scanning speech), impaired limb coordination, intention tremor (i.e., with movement), hypotonia. Differential diagnosis: Unsteady gait associated with vertigo can resemble gait instability of cerebellar disease but […]