Other median neuropathies.

Median mononeuropathy is common, with carpal tunnel syndrome the most frequently encountered acquired mononeuropathy in clinical practice. However, other disorders of the median nerve and many known anatomical variants can lead to misdiagnosis and unexpected surgical complications if their presence is not correctly identified. A number of inherited and acquired disorders can affect the median nerve proximal to the wrist, alone or accompanied by other affected peripheral nerves.

Financial vulnerability and the impact of COVID-19 on American households.

In May 2020, Westat, in partnership with Stanford University School of Medicine, conducted a nationally-representative household survey of American attitudes and behaviors regarding COVID-19. In this article, we examine what the Coronavirus Attitudes and Behaviors Survey tells us about the impact of COVID-19 on financial status and how this impact varies by demographic characteristics, the presence of health risk factors, and financial status (including employment factors). The survey reveals significant inequality in financial impact, as those who were most financially vulnerable prior to the pandemic found themselves under greater financial strain, while those who were more financially secure have experienced a neutral or even positive impact of the pandemic on household finances.

Electrodiagnostic Assessment of Radiculopathies.

This article discusses the electrodiagnostic assessment of radiculopathy. Relevant anatomy initially is reviewed followed by discussion surrounding the approach to nerve conduction studies and needle electrode examination when it comes to radiculopathy evaluation. Pitfalls of the electrodiagnosis versus clinical diagnosis of radiculopathy and the definitions of acute versus chronic, and active versus inactive, are reviewed.

Contemporary Neuroscience Core Curriculum for Medical Schools.

Medical students need to understand core neuroscience principles as a foundation for their required clinical experiences in neurology. In fact, they need a solid neuroscience foundation for their clinical experiences in all other medical disciplines also because the nervous system plays such a critical role in the function of every organ system. Because of the rapid pace of neuroscience discoveries, it is unrealistic to expect students to master the entire field.

Using and interpreting electrodiagnostic tests.

Electrodiagnostic testing, consisting of nerve conduction studies and needle electrode examination, serves as an extension of a neurologic examination for evaluating a variety of focal and generalized neuromuscular conditions. By providing important clues on location, chronicity, severity, and pathophysiology, it can help to establish a diagnosis, evaluate the need for surgery, and assess patients who do not improve as expected after surgery.

Subspecialization in clinical neurophysiology: Development and current status.

Objective: To describe the development and current status of training and certification in clinical neurophysiology (CNP); to explore the impact of the newer subspecialties in sleep medicine, neuromuscular medicine, and epilepsy; and to obtain information about aspects of practice in the subspecialty.

Methods: Information about training programs and certification was obtained from the records of the Accreditation Council for Graduate Medical Education and the American Board of Psychiatry and Neurology, and diplomates were surveyed about their CNP practice activities and attitudes toward certification/recertification.

Results: In the years since the first examination was administered, a robust number of CNP training programs developed, but recently, there has been a decrease in the number of programs and fellows, although the number of programs and fellows in the subspecialties of epilepsy, neuromuscular medicine, and sleep medicine has increased.

Age and sex differences in burnout, career satisfaction, and well-being in US neurologists.

Objective: To examine age and sex differences in burnout, career satisfaction, and well-being in US neurologists.

Methods: Quantitative and qualitative analyses of men's (n = 1,091) and women's (n = 580) responses to a 2016 survey of US neurologists.

Results: Emotional exhaustion in neurologists initially increased with age, then started to decrease as neurologists got older.

Burnout, career satisfaction, and well-being among US neurology residents and fellows in 2016.

Objective: To study prevalence of and factors contributing to burnout, career satisfaction, and well-being in US neurology residents and fellows.

Methods: A total of 938 US American Academy of Neurology member neurology residents and fellows were surveyed using standardized measures of burnout, career satisfaction, and well-being from January 19 to March 21, 2016.

Results: Response rate was 37.

Low Back Pain.

Purpose Of Review: This article provides an overview of evaluating and treating low back pain in the outpatient setting.

Recent Findings: As most cases of acute low back pain have a favorable prognosis, current guidelines on imaging studies recommend conservative treatment for 6 weeks prior to obtaining an MRI if no red flags are present. Of these red flags, a prior history of cancer is the strongest risk factor for a malignant etiology and requires urgent evaluation with MRI.

Burnout, career satisfaction, and well-being among US neurologists in 2016.

Objective: To study prevalence of and factors that contribute to burnout, career satisfaction, and well-being in US neurologists.

Methods: A total of 4,127 US American Academy of Neurology member neurologists who had finished training were surveyed using validated measures of burnout, career satisfaction, and well-being from January 19 to March 21, 2016.

Results: Response rate was 40.

Diagnostic Accuracy of Single Fiber Electromyography for Myasthenia Gravis in Patients Followed Longitudinally.

Introduction: The literature lacks data on accuracy of single fiber electromyography (SFEMG) for myasthenia gravis (MG) patients followed longitudinally.

Methods: We included patients with a clinical suspicion of MG who received SFEMG and follow-up at our institution between 2003 and 2013. Data collected included demographics, symptom details, clinical deficits, other diagnostic testing results, MG medication regimen, duration on treatment, response to therapy, and ultimate diagnosis after follow-up.

Bell palsy: Clinical examination and management.

Bell palsy is a common neurologic disorder characterized by acute facial mononeuropathy of unclear cause presenting with unilateral facial weakness. Careful examination and a detailed history are important in making an accurate diagnosis. Early recognition is essential, as treatment with corticosteroids within 72 hours of onset has been shown to hasten recovery.

Myelopathy due to degenerative and structural spine diseases.

Purpose Of Review: This article reviews the current evaluation and treatment of patients with myelopathy due to cervical spondylotic disease and other structural disorders of the spine.

Recent Findings: In patients with cervical spondylotic myelopathy, symptom duration, severity at baseline, and possibly age have been identified as key prognostic markers of clinical course and postsurgical outcome. Other potential markers include specific MRI and EMG findings.

Myasthenia gravis: newer therapies offer sustained improvement.

Myasthenia gravis is a prototypical antibody-mediated autoimmune neuromuscular disorder. Treatments have improved over the past 30 years, leading to significantly fewer deaths and better quality of life. Future research should further elucidate its pathogenesis, reveal better ways to diagnose it, and yield new treatments.

Sexualized and dangerous relationships: listening to the voices of low-income african american girls placed at risk for sexual exploitation.

Introduction: Youth from low-income, urban backgrounds face significant challenges to maintaining a positive developmental trajectory. Dangerous neighborhoods and stressed relationships are common in these settings and threaten adaptation by weakening the natural assets that undergird resilience. African American girls in these contexts face specific, multiple risks, including gender stereotyping, violence, and sexual exploitation.

Sural sensory nerve action potential, epidermal nerve fiber density, and quantitative sudomotor axon reflex in the healthy elderly.

Introduction: Polyneuropathy evaluation in older patients is often challenging due to conflicting data regarding normative values for peripheral nerve testing.

Methods: We characterized the results of sural nerve conduction studies, intraepidermal nerve fiber density (IENFD), and quantitative sudomotor axon reflex testing (QSART) in a prospective study of 50 healthy subjects aged ≥60 years.

Results: Of the 50 subjects, 48 (96%) had an obtainable sural sensory nerve action potential (SNAP).

Safety of repetitive nerve stimulation in patients with cardiac implantable electronic devices.

Introduction: Pacemakers and implantable cardioverter-defibrillators (ICDs) are vulnerable to inappropriate sensing of electromagnetic interference (EMI), such as from nerve conduction studies. We conducted a prospective study to assess the safety of repetitive nerve stimulation (RNS).

Methods: Fourteen patients undergoing insertion of 10 ICDs and 4 pacemakers under general anesthesia received RNS of the median, axillary, and spinal accessory nerves at 2 HZ and 50 HZ.