Addressing the Value of Multidisciplinary Clinical Care in Huntington's Disease: A Snapshot of a New Huntington's Disease Center.

Background: Clinical care for Huntington's disease (HD) is often provided in experienced centers that provide multidisciplinary care. However, the value of these centers and their uptake by HD families remain unknown.

Objective: To describe the services provided by a new HD center, including estimates of capture of the population served.

Psychiatric aspects of temporal lobe epilepsy before and after anterior temporal lobectomy.

Objectives: Psychopathology has been reported to be prevalent both before and after surgical treatment for medically intractable temporal lobe epilepsy. Individual patients were evaluated prospectively to assess the effect of anterior temporal lobectomy (ATL) on prevalence and severity of psychiatric disease.

Methods: Psychiatric status was assessed in a consecutive series of epilepsy patients before and 6 months after ATL using a structured psychiatric interview, psychiatric rating scales, and self report mood measures.

Transient postictal psychosis associated with a course of ECT.

Postictal psychoses, defined as episodic, time-limited psychiatric disturbances of diverse phenomenology, temporally related to a seizure or cluster of seizures, have been well described in patients with focal and generalized epilepsies. Although similar disturbances have been reported in patients undergoing electroconvulsive therapy (ECT), the syndrome of ECT-associated postictal psychosis has not been well described. We review the literature defining the syndrome of postictal psychosis (PIP) associated with the epilepsies, as well as reports of confusional and manic disturbances meeting accepted criteria for PIP, which have been reported to occur as complications of ECT.

An interdisciplinary perspective on the agitated brain injured patient.

The Special Interest Group on Brain Injury of the American Academy of Physical Medicine and Rehabilitation is developing a practice parameter for the agitated patient following traumatic brain injury (TBI). The eventual goal of the project is to create an interdisciplinary practice guideline for classifying and treating these patients using a common nosology, based on contributions from the literatures of neurosurgery, psychology, psychiatry and rehabilitation medicine. It is envisioned that a uniform classification system would ultimately promote interdisciplinary research and serve to advance our understanding and treatment of this patient population.

ECT in the treatment of patients with neurological and somatic disease.

Objective: An evaluation of the safety and efficacy of electroconvulsive therapy (ECT), for the treatment of patients with severe medical and neurological illness, was undertaken.

Method: The English-language literature reporting the use of ECT in patients with neurological and somatic disease was reviewed. This review included reports describing ECT used for the treatment of affective disturbances and catatonia in patients with concurrent neurological or somatic disease, as well as reports dealing with the efficacy of ECT for the treatment of certain neurological conditions for which it has been reported to have some benefit independent of its psychiatric effect.