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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 […]

188 ALZHEIMER’S DISEASE AND OTHER DEMENTIAS

188 ALZHEIMER’S DISEASE AND OTHER DEMENTIAS Harrison’s Manual of Medicine 188 ALZHEIMER’S DISEASE AND OTHER DEMENTIAS Dementia Alzheimer’s Disease (AD) Other Causes of Dementia Bibliography DEMENTIA Dementia is a deterioration in cognitive ability. Memory loss is most common, but other mental faculties affected may include attention, judgment, comprehension, orientation, learning, calculation, problem solving, mood, and […]

185 ASEPTIC MENINGITIS, VIRAL ENCEPHALITIS, AND PRION DISEASES

185 ASEPTIC MENINGITIS, VIRAL ENCEPHALITIS, AND PRION DISEASES Harrison’s Manual of Medicine 185 ASEPTIC MENINGITIS, VIRAL ENCEPHALITIS, AND PRION DISEASES Viral Meningitis Viral Encephalitis Herpes Zoster (Shingles) Neurologic Complications of HIV Infection Progressive Multifocal Leukoencephalopathy (PML) Prion Diseases Bibliography VIRAL MENINGITIS The syndrome of viral meningitis consists of fever, headache, and meningeal irritation associated with […]

182 SEIZURES AND EPILEPSY

182 SEIZURES AND EPILEPSY Harrison’s Manual of Medicine 182 SEIZURES AND EPILEPSY Seizure Classification Etiology Clinical Evaluation Bibliography A seizure is a paroxysmal event due to abnormal, excessive, hypersynchronous discharges from an aggregate of CNS neurons. Epilepsy is diagnosed when there are recurrent seizures due to a chronic, underlying process. Seizure Classification Proper seizure classification […]

179 HEMOCHROMATOSIS, PORPHYRIAS, AND WILSON’S DISEASE

179 HEMOCHROMATOSIS, PORPHYRIAS, AND WILSON’S DISEASE Harrison’s Manual of Medicine 179 HEMOCHROMATOSIS, PORPHYRIAS, AND WILSON’S DISEASE Hemochromatosis Porphyrias Wilson’s Disease Bibliography HEMOCHROMATOSIS Hemochromatosis is a disorder of iron storage that results in increased intestinal iron absorption with Fe deposition and damage to many tissues, including the liver, heart, pancreas, joints, and pituitary. Two major causes […]

177 OSTEOPOROSIS AND OSTEOMALACIA

177 OSTEOPOROSIS AND OSTEOMALACIA Harrison’s Manual of Medicine 177 OSTEOPOROSIS AND OSTEOMALACIA Osteoporosis Osteomalacia Bibliography OSTEOPOROSIS Osteoporosis is defined as a reduction in bone mass (or density) or the presence of fragility fracture. It is defined operationally as a bone density that falls 2.5 SD below the mean for a young normal individual (a T-score […]

176 HYPERCALCEMIC AND HYPOCALCEMIC DISORDERS

176 HYPERCALCEMIC AND HYPOCALCEMIC DISORDERS Harrison’s Manual of Medicine 176 HYPERCALCEMIC AND HYPOCALCEMIC DISORDERS Hypercalcemia Hypocalcemia Hypophosphatemia Hyperphosphatemia Hypomagnesemia Hypermagnesemia Bibliography HYPERCALCEMIA Hypercalcemia from any cause can result in fatigue, depression, mental confusion, anorexia, nausea, constipation, renal tubular defects, polyuria, a short QT interval, and arrhythmias. CNS and GI symptoms can occur at levels of […]

169 DISORDERS OF THE ANTERIOR PITUITARY AND HYPOTHALAMUS

169 DISORDERS OF THE ANTERIOR PITUITARY AND HYPOTHALAMUS Harrison’s Manual of Medicine 169 DISORDERS OF THE ANTERIOR PITUITARY AND HYPOTHALAMUS Pituitary Tumors Pituitary Hormone Hypersecretion Syndromes Hyperprolactinemia Acromegaly Cushing’s Disease Nonfunctioning and Gonadotropin-Producing Adenomas TSH-Secreting Adenomas Hypopituitarism Bibliography The anterior pituitary is often referred to as the “master gland” because, together with the hypothalamus, it […]

165 REACTIVE ARTHRITIS AND REITER’S SYNDROME

165 REACTIVE ARTHRITIS AND REITER’S SYNDROME Harrison’s Manual of Medicine 165 REACTIVE ARTHRITIS AND REITER’S SYNDROME Definition Pathogenesis Clinical Manifestations Evaluation Differential Diagnosis Outcome Bibliography Definition Reiter’s syndrome describes the triad of arthritis, conjunctivitis, and nongonococcal urethritis. This term is largely of historic interest and is now considered to be part of the spectrum of […]

163 GOUT, PSEUDOGOUT, AND RELATED DISEASES

163 GOUT, PSEUDOGOUT, AND RELATED DISEASES Harrison’s Manual of Medicine 163 GOUT, PSEUDOGOUT, AND RELATED DISEASES Gout Definition Pathogenesis Clinical Manifestations Evaluation Pseudogout Definition and Pathogenesis Clinical Manifestations Diagnosis Hydroxyapatite Arthropathy Calcium Oxalate Deposition Disease Bibliography GOUT Definition The term gout is applied to a spectrum of manifestations that may occur singly or in combination. […]