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Neurology

Welcome to the neurology category for physicians and pharmacists. This clinical category has links to a wide range of resources. Search and find neurology guidelines on a range of neurological disorders such as epilepsy, medical journal articles, prescribing advice and more.

American Academy of Neurology Practice Guidelines

Source: aan.com
Clinical Resource: Guidelines
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Last Checked: 17/06/13 Link Error: Report It

 

Association of British Neurologists Clinical Guidelines

Source: theabn.org
Clinical Resource: Guideline
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Last Checked: 21/08/15 Link Error: Report It

 

National Institute for Health and Care Excellence (NICE) Guidance > Neurological conditions

Source: nice.org.uk
Clinical Resource: Guidance
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Last Checked: 18/05/15 Link Error: Report It

 

Central nervous system - CLEAR: clinical enquiry and response service

The CLEAR service is delivered by a team of information professionals based at Healthcare Improvement Scotland and NHS Greater Glasgow and Clyde.

CLEAR aims to provide clinicians with summarised evidence relating to aetiology, diagnosis, prognosis and treatment queries about patient care.

Source: knowledge.scot.nhs.uk
Clinical Resource: Evidence Based Answers to Clinical Questions
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Last Checked: 22/04/13 Link Error: Report It

 

BestBETs
Neurology

BETs were developed in the Emergency Department of Manchester Royal Infirmary, UK, to provide rapid evidence-based answers to real-life clinical questions, using a systematic approach to reviewing the literature. BETs take into account the shortcomings of much current evidence, allowing physicians to make the best of what there is.

Source: bestbets.org
Clinical Resource: Evidence Based Answers to Clinical Questions
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Last Checked: 16/05/13 Link Error: Report It

 

The Cochrane Collaboration
Cochrane Reviews

The Cochrane Collaboration is an international, non-profit, independent organisation, established to ensure that up-to-date, accurate information about the effects of healthcare interventions is readily available worldwide. It produces and disseminates systematic reviews of healthcare interventions, and promotes the search for evidence in the form of clinical trials and other studies of the effects of interventions.

Topics:

Dementia and Cognition
Epilepsy
Movement Disorders
Multiple Sclerosis
Peripheral Neuropathy
Sroke

Source: cochrane.org
Clinical Resource: Systematic Reviews
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Last Checked: 13/07/15 Link Error: Report It

 

Bandolier Knowledge
Neurological disorders

In these pages are collected the stories from Bandolier relating to neurological problems.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

Foundation for Education and Research in Neurological Emergencies

Source: ferne.org
Clinical Resource: Various
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Last Checked: 16/05/13 Link Error: Report It

 

The Movement Disorder Society Evidence-Based Medicine Reviews and Task Force Position Papers in Movement Disorders

Source: movementdisorders.org
Clinical Resource: Evidence Based Reviews and Position Papers
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Last Checked: 16/05/13 Link Error: Report It

 

Drug-Induced Movement Disorders

Significant proportion of drug-induced movement disorders is related to antipsychotic medications and neuroleptics are the commonest.

Source: fmshk.org
Clinical Resource: Bulletin
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Last Checked: 16/05/13 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Diagnosis and Pharmacological Management of Parkinson’s Disease

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

COMPASS Therapeutic Notes on Management of Parkinson’s Disease

In this issue

Introduction
Drug Treatment in early PD
Motor complications
Depression in PD
Dementia in PD
Psychosis in PD

Source: hscbusiness.hscni.net
Clinical Resource: Bulletin
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Last Checked: 22/11/16 Link Error: Report It

 

Parkinson’s Disease
Key Points for the Pharmacist

The common pathologic feature in PD and secondary parkinsonism is striatal dopamine deficiency. In patients with PD, cell loss occurs in the substantia nigra with the formation of Lewy bodies (intracellular neuronal inclusion bodies). Lewy bodies are not present in secondary parkinsonism; however, the nigral striatal pathway may be impaired, and nigral cell loss or loss of striatal cellular elements may occur.

Source: uspharmacist.com
Clinical Resource: Journal Article
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Last Checked: 16/05/13 Link Error: Report It

 

Managing the major non-motor symptoms of Parkinson’s disease

Non-motor symptoms such as depression, sleep disturbances or hallucinations are common in Parkinson’s disease (PD), but often these are under-recognised and poorly treated. The frequency of non-motor symptoms usually increases with severity of disease and thus are more likely to affect older patients, many of whom may have had PD for 15 years or more. In this article, Drs Doug MacMahon and Simon McIntosh discuss the major non-motor symptoms.

Source: gmjournal.co.uk
Clinical Resource: Journal Article
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Last Checked: 05/03/13 Link Error: Report It

 

Recognition and management of neuropsychiatric complications in Parkinson’s disease

In this article, we review the primary care approach to the recognition, management and prevention of neuropsychiatric disorders in patients with Parkinson’s disease.

Source: cmaj.ca
Clinical Resource: Journal Article
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Last Checked: 16/05/13 Link Error: Report It

 

 

Restless Legs Syndrome Medical Bulletin: A Publication for Healthcare Providers

This is our current comprehensive bulletin describing RLS for healthcare providers. Sections include prevalence, diagnosis, and treatment.

Source: rls.org
Clinical Resource: Bulletin
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Last Checked: 16/05/13 Link Error: Report It

 

Bandolier Knowledge
Restless legs syndrome

This site looks at the best evidence we can find on restless legs.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Management of Patients with Dementia

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

Clinical practice with anti-dementia drugs: a revised (second) consensus statement from the British Association for Psychopharmacology

Source: bap.org.uk
Clinical Resource: Guideline
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Last Checked: 16/05/13 Link Error: Report It

 

Guideline for Alzheimer’s Disease Management
California Workgroup on Guidelines for Alzheimer’s Disease Management

Source: caalz.org
Clinical Resource: Guideline
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Last Checked: 20/08/15 Link Error: Report It

 

Alzheimer Europe

Welcome to the Alzheimer Europe website. We are a non-governmental organisation aimed at raising awareness of all forms of dementia by creating a common European platform through co-ordination and co-operation between Alzheimer organisations throughout Europe. Alzheimer Europe is also a source of information on all aspects of dementia.

Source: alzheimer-europe.org
Clinical Resource: Various
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Last Checked: 16/05/13 Link Error: Report It

 

Alzheimer's Disease | Alzheimer's Association

  • Diagnosing Alzheimer's
  • Treating Alzheimer's
Source: alz.org
Clinical Resource: Various
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Last Checked: 16/05/13 Link Error: Report It

 

Dementia

The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.

Source: webarchive.org.uk
Clinical Resource: e-Learning
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Last Checked: 24/04/15 Link Error: Report It

 

Alzheimer Research Forum

The Alzheimer Research Forum, founded in 1996, is the web's most dynamic scientific community dedicated to understanding Alzheimer's disease and related disorders. Access to the web site is free to all. Our editorial priorities are as diverse as the needs of the research community. The web site reports on the latest scientific findings, from basic research to clinical trials; creates and maintains public databases of essential research data and reagents, and produces discussion forums to promote debate, speed the dissemination of new ideas, and break down barriers across the numerous disciplines that can contribute to the global effort to cure Alzheimer's disease.

Source: alzforum.org
Clinical Resource: Various
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Last Checked: 16/05/13 Link Error: Report It

 

Lewy Body Dementia Association
For Professionals

The Lewy Body Dementia Association (LBDA) is a 501(c)(3) nonprofit organization dedicated to raising awareness of the Lewy body dementias (LBD), supporting patients, their families and caregivers, and promoting scientific advances. The Association's purposes are charitable, educational, and scientific.

Source: lbda.org
Clinical Resource: Various
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Last Checked: 16/05/13 Link Error: Report It

 

Reference Guide to Prescribing Cholinesterase Inhibitors

Source: gov.bc.ca
Clinical Resource: Guide
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Last Checked: 16/05/13 Link Error: Report It

 

Cholinergic–Anticholinergic Drug Interactions

When drugs from opposing pharmacologic classes are coprescribed, an antagonistic response may occur, reducing the pharmacodynamic response of one or both drugs. The coadministration of anticholinergic agents with cholinergic drugs has been shown to inhibit the efficacy of the cholinergic agents.

Source: hanstenandhorn.com
Clinical Resource: Journal Article
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Last Checked: 05/06/15 Link Error: Report It

 

Dementia - Behavioural and Psychological Symptoms (BPSD), Use of Antipsychotics
Pan Mersey Area Prescribing Committee Guideline

Source: panmerseyapc.nhs.uk
Clinical Resource: Guideline
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Last Checked: 08/08/16 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Diagnosis and Management of Epilepsy in Adults

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

 

American Epilepsy Society Guidelines

Source: aesnet.org
Clinical Resource: Guidelines
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Last Checked: 07/04/14 Link Error: Report It

 

American Epilepsy Society Position Statements

Source: aesnet.org
Clinical Resource: Position Statements
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Last Checked: 07/04/14 Link Error: Report It

 

epilepsy.com for Professionals

Professionals Homepage

About Epilepsy & Seizures
This section contains information about epilepsy syndromes and seizure classifications, as well as the psychiatric and behavioral aspects of epilepsy.

Co-Existing Disorders
In this section, the interaction between epilepsy and disorders are discussed.

Specialized Populations
In this section, specialized populations are identified and discussed in relation to epilepsy.

Diagnosis & Treatment
This section outlines epilepsy-related quality measures that were published in Neurology, examination and testing procedures involved with diagnosing epilepsy, and approaches to pharmaceutical and non-pharmaceutical treatments.

Refractory Seizures
This section provides a practical approach to the evaluation and treatment of these patients.

Challenging Cases

Source: epilepsy.com
Clinical Resource: Various
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Last Checked: 08/04/14 Link Error: Report It

 

The Merck Manual for Health Care Professionals
Seizure Disorders

Source: merckmanuals.com
Clinical Resource: Manual
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Last Checked: 16/05/13 Link Error: Report It

 

Epilepsy

Chapter Section Links

  • Definition
  • Prevalence
  • Pathophysiology
  • Signs and symptoms
  • Diagnosis
  • Treatment
  • Outcomes
Source: clevelandclinicmeded.com
Clinical Resource: Medical Reference
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Last Checked: 16/05/13 Link Error: Report It

 

Epilepsy

The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.

Source: webarchive.org.uk
Clinical Resource: e-Learning
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Last Checked: 24/04/15 Link Error: Report It

 

Epilepsy in Later Life
A Good Practice Guide

This guide takes a problem-based approach to care. It does not cover every aspect of care of older people with possible epilepsy. Nor does it cover every aspect of care of other problems that can cause diagnostic confusion (syncope, transient ischemic attack (TIA), simple falls, delirium or sleep disorders). However, the guideline does focus on key steps in the differential diagnosis of a patient with possible epilepsy; key features of the specific treatment of established epilepsy and a basic strategy for care for older people presenting with symptoms that could be due to epilepsy.

Source: epilepsyscotland.org.uk
Clinical Resource: Guide
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Last Checked: 16/05/13 Link Error: Report It

 

Concise guide to the currently available drug options in epilepsy

Our Drug review of epilepsy provides an overview of the wide range of first-line, second-line and alternative antiepileptic drugs available, followed by a review of the prescription data and sources of further information.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 16/05/13 Link Error: Report It

 

Antiepileptics: changing products : MHRA

This section of the website provides information about switching between manufacturers’ products of antiepileptic drugs, including switching between branded products and generic products, and between different generic products of a particular drug.

Source: webarchive.nationalarchives.gov.uk
Clinical Resource: Various
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Last Checked: 22/11/16 Link Error: Report It

 

Epilepsy Action Position Statement on the Consistency of Supply

Source: epilepsy.org.uk
Clinical Resource: Position Statement
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Last Checked: 22/11/16 Link Error: Report It

 

Epilepsy Society of Australia Position Statement: Generic drug use in epilepsy

Source: epilepsy-society.org.au
Clinical Resource: Position Statement
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Last Checked: 22/11/16 Link Error: Report It

 

Generic AEDs: Current Standards and Recommendations

Switching AED Formulations: Defining the Issues

Understanding the Ramifications of Switching Among AEDs: What Are the Data?

Roundtable Discussion

Source: utasip.com
Clinical Resource: Review Articles and Roundtable Discussion
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Last Checked: 22/11/16 Link Error: Report It

 

Clinically relevant drug interactions with antiepileptic drugs

Comprehensive reviews of interactions involving AEDs have been published recently. The purpose of the present review is to highlight those which, because of their frequency or magnitude, are especially likely to have adverse clinical consequences.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 16/05/13 Link Error: Report It

 

Faculty of Sexual and Reproductive Healthcare Clinical Effectiveness Unit Statement
Antiepileptic Drugs and Contraception

Source: fsrh.org
Clinical Resource: Statement
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Last Checked: 10/06/15 Link Error: Report It

 

 

The clinical relevance of pharmacokinetics and drug interactions with anti epileptic drugs

In this paper an overview will be given of how knowledge of pharmacokinetic mechanisms determines which pharmacokinetic characteristics an AED should have. Various clinical factors such as age, underlying physiological conditions and drug interactions will also affect the pharmacokinetics and efficacy of AED medication. It will be shown how by anticipating changes in pharmacokinetics due to possible drug interactions, or alterations in one of the pharmacokinetic parameters, adverse effects and breakthrough seizures may be averted and aid in the choice of optimal AED therapy for each patient.

Source: mcppnet.org
Clinical Resource: Journal Article
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Last Checked: 17/02/14 Link Error: Report It

 

Therapeutic drug monitoring | Epilepsy Society

Monitoring drug concentrations

When should drug concentrations be monitored?

Sample type

In most clinical settings the measurement of total serum concentrations will suffice and indeed most routine methods for measuring AEDs in sera do not discriminate between the component of drug that is free (unbound) and that that is bound to serum proteins.

Source: epilepsysociety.org.uk
Clinical Resource:
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Monitoring Antiepileptic Drugs: A Level-Headed Approach

This review examines the elusive concept of therapeutic AED blood levels and potential uses and abuses of blood level monitoring, reinforcing appropriate uses for blood levels to ensure compliance and adjust for altered AED pharmacokinetics in the context of aging and disease states, pregnancy, or drug interactions.

Source: nih.gov
Clinical Resource: Journal Article
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Last Checked: 17/02/14 Link Error: Report It

 

Phenytoin

In this article we apply to phenytoin the criteria that must be fulfilled in part or in full before the measurement of its plasma concentration can be considered worth while.

Source: europepmc.org
Clinical Resource: Journal Article
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Last Checked: 07/04/14 Link Error: Report It

 

Preventing phenytoin intoxication: Safer use of a familiar anticonvulsant

Phenytoin carries a special risk of dose-related toxicity, due to its saturation (zero-order) pharmacokinetics: serum levels often rise much more than would ordinarily be expected after initiating or increasing a maintenance dose. This predicts a vulnerability to toxicity, but does not predict exactly when this will occur in the individual.

Source: jfponline.com
Clinical Resource: Journal Article
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Last Checked: 17/02/14 Link Error: Report It

 

Adjusting phenytoin doses in a patient with co-morbidities

This article describes the application of therapeutic drug monitoring to achieve optimal dosing of phenytoin in an elderly patient with co-morbid conditions.

Source: clinicalpharmacy.org.uk
Clinical Resource: Journal Article
Register to Access Content: Yes - registration is FREE to healthcare professionals

Last Checked: 17/02/14 Link Error: Report It

 

Therapeutic drug monitoring for phenytoin

The antiepileptic phenytoin requires therapeutic drug monitoring during its use to ensure adequate seizure control and to avoid toxicity.

Source: auspharmlist.net.au
Clinical Resource: Pharmacy E-Bulletin
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Last Checked: 17/02/14 Link Error: Report It

 

Monitoring phenytoin serum concentrations

Phenytoin is a commonly used anticonvulsant but is one of the most difficult drugs to dose appropriately. It has a narrow therapeutic range and, because of saturable metabolism, small dose increases can result in disproportionately large increases in serum concentrations.

Source: druginformation.co.nz
Clinical Resource: Drug Information Service Bulletin
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Last Checked: 17/02/14 Link Error: Report It

 

Administration of intravenous IV phenytoin injection

To clarify the two correct methods of administering IV phenytoin, the Medicines Governance Project Team have prepared the enclosed administration summary sheet.

Update to Safety Memo 4

Source: medicinesgovernance.hscni.net
Clinical Resource: Memo and Update
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Last Checked: 22/02/17 Link Error: Report It

 

Antiepileptic Drug Pregnancy Registry
Publications & Press

The North American AED (antiepileptic drug) Pregnancy Registry was established in 1997 for pregnant women in the United States and Canada at the Massachusetts General Hospital in Boston, Massachusetts. It was established with funds provided by six companies that manufacture "old" and "new" anticonvulsant drugs. The major objective is to obtain and publish information on the frequency of major malformations, such as heart defects, spina bifida and cleft lip, among infants whose mothers had taken one or more AEDs to prevent seizures or to treat any other medical condition. The highest priority was new information on the many "new" AEDs marketed in the past 10 years.

Source: aedpregnancyregistry.org
Clinical Resource: Various
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Last Checked: 07/05/14 Link Error: Report It

 

Management of women with epilepsy before and during pregnancy

In this article, Dr Hart discusses the special precautions that need to be taken when caring for women with epilepsy before and during pregnancy, including preconception counselling, adjustment of antiepileptic drugs and monitoring of the mother and fetus.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 07/05/14 Link Error: Report It

 

Epilepsy Action Position Statement
Comment on the safety of sodium valproate in women of child bearing potential

Source: epilepsy.org.uk
Clinical Resource: Position Statement
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Last Checked: 07/05/14 Link Error: Report It

 

Contraceptive Choices for Women With Epilepsy Guidelines
A statement from the Special Interest Group in Epilepsy in the South West Peninsula of England

Source: plymouth.ac.uk
Clinical Resource: Guideline
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Last Checked: 16/05/13 Link Error: Report It

 

Antidepressant Drugs: Indications and Guidelines for Use in Epilepsy

Epilepsy patients who are diagnosed with clinical depression are often not treated with antidepressant drugs. There are a number of arguments for avoiding antidepressants in a person with active epilepsy; but there also are irrational worries. On the patient’s side, there is often the fundamental problem that a diagnosis of depression cannot be accepted because psychiatric disorders are seen as even more stigmatizing than epilepsy. However, for the physician, who most often has little or no psychiatric training, there is often an inappropriate fear of using antidepressants because of proconvulsive properties and of kinetic and dynamic interactions with antiepileptic drugs (AEDs).

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 16/05/13 Link Error: Report It

 

Antidepressant-induced seizures

The incidence of antidepressant induced seizures ranges from 0.1–4.0%, with the greatest risk being in patients with identifiable risk factors, as listed below. The mechanisms by which antidepressants cause seizures are unclear.

Source: auspharmlist.net.au
Clinical Resource: Pharmacy E-Bulletin
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Last Checked: 16/05/13 Link Error: Report It

 

Clinical Significance of Pharmacokinetic Interactions Between Antiepileptic and Psychotropic Drugs

The purpose of this article is to provide a concise overview of pharmacokinetic interactions between psychotropic agents and antiepileptic drugs (AEDs).

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 17/02/14 Link Error: Report It

 

Suggestions for Management of Anticonvulsant-Antiretroviral Interactions in HIV

Source: hivclinic.ca
Clinical Resource:
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Last Checked: 15/12/14 Link Error: Report It

 

Complementary Corner: Essential oils associated with seizures

Essential oils, obtained from plants, are widely used in aromatherapy and are included in some medicines. Healthcare professionals are reminded that these substances, when administered orally or topically, can rarely cause seizures in young children and in those patients with epilepsy.

Source: medsafe.govt.nz
Clinical Resource: Prescriber Update Article
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Last Checked: 24/02/14 Link Error: Report It

 

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Management of Patients With Stroke: Identification and Management of Dysphagia

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

 

American Heart Association/American Stroke Association Statements and Guidelines

Source: my.americanheart.org
Clinical Resource: Statements and Guidelines
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Last Checked: 16/05/13 Link Error: Report It

 

European Stroke Organization Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack 2008

European Stroke Organization Guideline Update – January 2009

The ESO Guidelines have been updated with regard to thrombolytic therapy. The modifications were discussed and prepared at the Karolinska Stroke Update Meeting, November 2008, and have been approved by the ESO Guideline Committee and the ESO Executive Committee.

Source: eso-stroke.org
Clinical Resource: Guideline and Update
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Last Checked: 19/08/15 Link Error: Report It

 

European Stroke Organization Guidelines for the Management of Intracranial Aneurysms and Subarachnoid Haemorrhage

Source: eso-stroke.org
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

European Stroke Organisation Guidelines for the Management of Spontaneous Intracerebral Hemorrhage

Source: eso-stroke.org
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

Canadian Best Practice Recommendations for Stroke Care

The Canadian Best Practice Recommendations for Stroke Care are intended to provide up-to-date evidence-based guidelines for the prevention and management of stroke.

Source: strokebestpractices.ca
Clinical Resource: Recommendations
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Last Checked: 22/04/13 Link Error: Report It

 

The Internet Stroke Center
Stroke Resources for Health Professionals

The Internet Stroke Center provides health professionals with multiple tools and educational presentations about stroke assessment, stroke treatment and management. Physicians and medical students will also find a library of more than 1800 images of cerebrovascular and neurological diseases.

Source: strokecenter.org
Clinical Resource: Various
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Last Checked: 22/04/13 Link Error: Report It

 

Bandolier Knowledge
Stroke

In these pages are collected the stories from Bandolier relating to stroke.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

Cardiovascular disease - Stroke

The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.

Source: webarchive.org.uk
Clinical Resource: e-Learning
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Last Checked: 24/04/15 Link Error: Report It

 

European Stroke Organisation
Frequently Asked Questions on Stroke

  1. Introduction to the Management of Stroke
  2. Epidemiology of Stroke
  3. High Blood Pressure
  4. Diabetes and Stroke
  5. Lipids and Stroke
  6. Other Risk Factors for Stroke
  7. Carotid Surgery
  8. Antiplatelets, Therapy for Stroke Prevention
  9. Anticoagulant Therapy and Stroke Prevention
  10. Prevention in Atrial Fibrillation and Other Cardiac Sources of Embolism
  11. Stroke Services
Source: eso-stroke.org
Clinical Resource: Frequently Asked Questions
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Last Checked: 19/08/15 Link Error: Report It

 

Massachusetts General Hospital
Stroke Service

Acute Ischemic Stroke

The protocols and guidelines we use to treat acute ischemic stroke.

  • t-PA Dosing Calculator
  • Thrombolysis
  • Eptifibatide Dosing
Source: massgeneral.org
Clinical Resource: Various
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Last Checked: 22/04/13 Link Error: Report It

 

SPARC - Stroke Prevention in Atrial Fibrillation Risk Tool

for estimating risk of stroke and benefits & risks of antithrombotic therapy in patients with chronic atrial fibrillation

Source: sparctool.com
Clinical Resource: Tool
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Last Checked: 22/04/13 Link Error: Report It

 

Stroke Risk Calculator

This tool can predict a patient's stroke risk 90 days after a Transient Ischemic Attack (TIA).

Source: bmc.org
Clinical Resource: Tool
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Last Checked: 22/04/13 Link Error: Report It

 

Choice of antiplatelet agent for secondary prevention of stroke

The risk of recurrent stroke is as high as 43% over 10 years. Antiplatelet therapy is an accepted strategy for reduction in this risk. The common choices are aspirin, aspirin plus extended release Dipyridamole (ASA-ESDP), and clopidogrel. When selecting an antiplatelet there should be consideration of co-morbidities (especially acute coronary disease), tolerance, and recurrence of stroke while on an antiplatelet.

Source: auspharmlist.net.au
Clinical Resource: Pharmacy E-Bulletin
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Last Checked: 22/04/13 Link Error: Report It

 

Glycaemic management during the inpatient enteral feeding of stroke patients with diabetes
Joint British Diabetes Societies (JBDS) for inpatient care

This document has been produced by the Joint British Diabetes Societies for Inpatient Care (JBDS – IP) on behalf of Diabetes UK, the Association of British Clinical Diabetologists (ABCD), and the Diabetes Inpatient Specialist Nurse (DISN) UK Group, in collaboration with NHS Diabetes and the Primary Care Diabetes Society (PCDS).

Source: diabetologists-abcd.org.uk
Clinical Resource: Guideline
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Last Checked: 22/04/13 Link Error: Report It

 

Atrial fibrillation and stroke prevention in elderly people

This article reviews antiplatelet and anticoagulant treatments used for prevention of stroke in patients with atrial fibrillation, with reference to evidence for risk of bleeding, and discusses risk stratification for starting warfarin.

Source: gmjournal.co.uk
Clinical Resource: Journal Article
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Last Checked: 05/03/13 Link Error: Report It

 

 

Welcome to the MIPCA guidelines for the management of migraine

Welcome to this electronic document, which summarises the new Migraine in Primary Care Advisors (MIPCA) guidelines for the management of migraine in primary care in a dynamic and interactive form. MIPCA has devised rational, evidence-based guidelines for the management of migraine that are categorised into several clinically appropriate areas:

  • Initial assessment of the patient
  • Diagnosis of migraine and other headache subtypes
  • Assessment of illness severity
  • Initial treatment of the patient
  • Follow-up treatment
  • Practical aspects of managing migraine in the clinic
Source: mipca.org.uk
Clinical Resource: Guideline
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Last Checked: 16/05/13 Link Error: Report It

 

How Do I Do It Reference for the Acute Treatment of Migraine

"This is a description of an individual expert practitioner's approach, presented to give the learner some practical ideas.

Source: americanheadachesociety.org
Clinical Resource: Treatment Recommendation
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Last Checked: 07/06/13 Link Error: Report It

 

“Review & Update: Migraine”

The objectives of this lesson are such that upon completion the participant will be able to:

  1. List types & symptoms of migraine
  2. Discuss factors that may trigger migraine attacks
  3. Describe relevance of diet to migraine attacks
  4. State the role of OTCs in treating migraine
  5. Describe impact of lifestyle on migraine
  6. List & discuss prescription drugs used for migraine
Source: wfprofessional.com
Clinical Resource: CE / CPD / Learning
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Last Checked: 06/06/13 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Diagnosis and Management of Headaches in Adults

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

IHS Classification ICHD - II

Two years after the publication of the 2nd Edition of The International Headache Classification (ICHD-2), we are now ready to launch a web based edition. This web based version has many facilities that are not present in the printed version or a simple electronic file.

Since a Headache Classification cannot be learned by heart, it is of immense value that doctors all over the world are now able to go on the web and look after whatever question they may have regarding ICHD-2.

Table of Contents

Part I: The Primary Headaches
Part II: The Secondary Headaches
Part III: Cranial Neuralgias, Central and Primary Facial Pain And Other Headaches

Source: ihs-classification.org
Clinical Resource: Classification
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Last Checked: 16/05/13 Link Error: Report It

 

Adult Headache Guideline
Western Sussex Hospitals NHS

Headaches: when to admit and when to refer. A Guide for GPs

Source: gp.westernsussexhospitals.nhs.uk
Clinical Resource: Guideline
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Last Checked: 19/08/15 Link Error: Report It

 

Bandolier Knowledge
Migraine and headache

The Bandolier migraine site contains stories from Bandolier , plus abstracts of systematic reviews, meta-analyses, or other studies about migraine.

Source: bandolier.org.uk
Clinical Resource: Evidence Based Abstracts
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Last Checked: 13/06/17 Link Error: Report It

 

Migraine

The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.

Source: webarchive.org.uk
Clinical Resource: e-Learning
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Last Checked: 24/04/15 Link Error: Report It

 

Brainstorm

The American Headache Society (AHS) welcomes you to Brainstorm—The Primary Care Migraine Partnership’s collaborative, interactive educational program. The Primary Care Migraine Partnership is an innovative educational program designed by primary care physicians and neurologists for primary care physicians. This dynamic program results from an extensive needs assessment, including a comprehensive review of the primary care literature and more than 80 hours of interviews with primary care physicians regarding the challenges faced in treating migraine patients.

Source: americanheadachesociety.org
Clinical Resource: CE / CPD / CME / Learning
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Last Checked: 16/05/13 Link Error: Report It

 

American Headache Society Headache Fact Sheets

Downloadable Fact Sheets on a Number of Topics of Importance in Headache Medicine

Source: americanheadachesociety.org
Clinical Resource: Factsheets
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Last Checked: 16/05/13 Link Error: Report It

 

How Do I Do It Reference for Menstrual Migraine

"This is a description of an individual expert practitioner's approach, presented to give the learner some practical ideas.

Source: americanheadachesociety.org
Clinical Resource: Treatment Recommendation
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Last Checked: 16/05/13 Link Error: Report It

 

Migraine
Rational Use of Opioids in Chronic or Recurrent Non-malignant Pain

These guidelines were developed by the NSW Therapeutic Assessment Group Inc (NSW TAG).

Source: ciap.health.nsw.gov.au/nswtag
Clinical Resource: Guideline
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Last Checked: 16/05/13 Link Error: Report It

 

Off-Label Drug Uses
Lisinopril: Prevention of Migraine (Adults)

Source: thomasland.com
Clinical Resource: Journal Article
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Last Checked: 16/05/13 Link Error: Report It

 

Off-Label Drug Uses
Olmesartan: Migraine Prevention

Source: thomasland.com
Clinical Resource: Journal Article
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Last Checked: 26/11/15 Link Error: Report It

 

Can Triptans and SSRIs Be Used Together?

The FDA has issued a Public Health Advisory that warns of possible serotonin syndrome in patients receiving 5-hydroxytryptamine receptor agonists (triptans) together with either selective serotonin reuptake inhibitors (SSRIs) or selective serotonin norepinephrine reuptake inhibitors (SNRIs).

Source: hanstenandhorn.com
Clinical Resource: Journal Article
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Last Checked: 05/06/15 Link Error: Report It

 

Practical management of medication-overuse headache

Here, we summarize available data on MOH, including clinical features, drugs used in withdrawal, as well as withdrawal strategies that have been described in the literature. We also include a detailed description of an in-patient and out-patient withdrawal procedure, reflecting personal experience and opinion of the authors.

Source: actaneurologica.be
Clinical Resource: Journal Article
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Last Checked: 16/05/13 Link Error: Report It

 

Medication overuse headache

Patients commonly take analgesics for headaches. However, chronic use of analgesics for headache can cause headache as a withdrawal phenomenon. Epidemiological data suggest that 4% of the population misuse pain medication, and that a minimum 1% of the general population in Europe, North America and Asia suffer from medication overuse headache.

Source: nps.org.au
Clinical Resource: Journal Article
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Last Checked: 08/08/16 Link Error: Report It

 

Multiple Sclerosis Society
For professionals

The MS Society works with professionals to improve the lives of people affected by MS.

Find resources, events and funding to develop and improve services for people with MS.

Source: mssociety.org.uk
Clinical Resource: Various
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Last Checked: 16/05/13 Link Error: Report It

 

Neuropathic Pain Management | Pain Community Centre

The ‘Neuropathic Pain Management’ course discusses ways of managing neuropathic pain. It includes examples of interventions (both pharmacological and non-pharmacological approaches) that are commonly used including case studies.

Learning Materials

Managing Neuropathic Pain in Primary Care: Part 2
Management of Neuropathic Cancer Pain - A Case Study
Assessment of Neuropathic Pain
Pain assessment and Treatment (Primary Care)
Phantom Limb Pain
Neuropathic Pain
Non-Pharmacologic Treatment of Neuropathic Pain: Introduction
Non-Pharmacologic Treatment of Neuropathic Pain: Biopsychosocial Approach

Source: paincommunitycentre.org
Clinical Resource: CPD / CE / CME / Learning
Register to Access Content: Yes - registration is FREE to healthcare professionals

Last Checked: 17/06/14 Link Error: Report It

 

Diagnosis and Classification of Neuropathic Pain

This issue of Pain: Clinical Updates focuses on the clinical diagnosis of neuropathic pain and also considers the aims of treatment and assessment of treatment effects in the clinic.

Source: iasp-pain.org
Clinical Resource: Newsletter
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Last Checked: 07/05/15 Link Error: Report It

 

Clinical approach to patients with neuropathic pain

This article reviews how to classify a patient’s pain on the basis of the clinical picture, discusses the physiology of pain, and provides several approaches to managing common neuropathic pain syndromes, with two cases to illustrate the art and the science of treatment.

Source: mdedge.com
Clinical Resource: Journal Article
Register to Access Content: Yes - registration is FREE

Last Checked: 19/06/17 Link Error: Report It

 

Pharmacological Management of Neuropathic Pain

Neuropathic pain may arise as a consequence of a lesion or disease affecting the somatosensory system. Neuropathic pain is estimated to afflict as much as 7–8% of the general population in Europe. Classical examples include diabetic polyneuropathies, postherpetic neuralgia, trigeminal neuralgia, central poststroke pain, and spinal cord injury pain, although traumatic/postsurgical neuropathies and painful radiculopathies represent common conditions in the general population.

Source: iasp-pain.org
Clinical Resource: Newsletter
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Last Checked: 07/05/15 Link Error: Report It

 

Pharmacologic Treatment of Neuropathic Pain

Source: paineducation.vcu.edu
Clinical Resource: Table
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Last Checked: 16/05/13 Link Error: Report It

 

Pharmacological treatment of neuropathic pain in older persons

Interest and research into the mechanisms and treatment of neuropathic pain have increased during recent years, but current treatment is still far from satisfactory. The European Federation of Neurological Societies (EFNS) Task Force recently published guidelines for the pharmacological treatment of neuropathic pain. However, no particular consideration is given as to how the recommendations are applicable to the elderly population. This paper will review the guidelines in relation to this population and evaluate the existing evidence relating to the use of these drugs in older persons.

Source: nih.gov
Clinical Resource: Journal Article
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Last Checked: 16/05/13 Link Error: Report It

 

Neuropathic Pain Treatment

A variety of pharmacologic agents from different therapeutic classes have been used for NP treatment. Even so, only 40-60% of patients obtain even partial pain relief for NP with existing pharmacologic agents. Methodology, small sample sizes, short duration studies, lack of head to head trials, and variability in drug classes for treatment of different types of NP limit comparative analysis of many medications.

Source: oregonstate.edu
Clinical Resource: Newsletter
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Last Checked: 19/08/15 Link Error: Report It

 

Gabapentin in the treatment of neuropathic pain

This paper reviews the pharmacology and clinical effectiveness of gabapentin in the treatment of neuropathic pain.

Source: eapcnet.eu
Clinical Resource: Journal Article
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Last Checked: 16/05/13 Link Error: Report It

 

Pregabalin for Neuropathic Pain

Pregabalin is the first “adjuvant” analgesic whose primary indication is treatment of neuropathic pain. But is pregabalin really unique? Is it more effective, safer, easier to use or less expensive than current alternatives? Pregabalin’s closest comparator is gabapentin, an anticonvulsant that has been increasingly used for neuropathic pain in recent years.

Source: stacommunications.com
Clinical Resource: Journal Article
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Last Checked: 16/05/13 Link Error: Report It

 

Conversion of Gabapentin to Pregabalin: Simple & easy

Dose equivalencies of Gabapentin & Pregabalin for the conversion protocol

Source: apsoc.org.au
Clinical Resource: Newsletter
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Last Checked: 28/11/16 Link Error: Report It

 

Guidelines for General Practitioners on Treatment of Pain in Post-Herpetic Neuralgia

Source: shinglessupport.org.uk
Clinical Resource: Guideline
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Last Checked: 16/05/13 Link Error: Report It

 

Recommendations for the Management of Herpes Zoster

The objective of this supplement to Clinical Infectious Diseases is to improve the care of patients with HZ by providing practical, evidence-based recommendations that take into account clinical efficacy, adverse effects, impact on quality of life, and costs of treatment. Pharmacologic management is emphasized, because few nonpharmacologic approaches have been evaluated in randomized controlled trials. These recommendations apply only to the acute phase of HZ; detailed recommendations for the treatment of postherpetic neuralgia (PHN), the most common complication of HZ, appear elsewhere. We describe the pathogenesis, epidemiological aspects, clinical aspects, and complications of HZ, and then we review the literature on the treatment of HZ and present specific treatment recommendations.

Source: cid.oxfordjournals.org
Clinical Resource: Supplement Article
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Last Checked: 19/03/13 Link Error: Report It

 

Herpes Zoster (Shingles) and Postherpetic Neuralgia

This review focuses on the clinical manifestations and treatment of HZ and PHN, as well as the appropriate use of the HZ vaccine.

Source: mayoclinicproceedings.org
Clinical Resource: Journal Article
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Last Checked: 16/05/13 Link Error: Report It

 

The prevention and management of herpes zoster

Here, we provide an overview of the new vaccine and introduce clinicians to a new clinical paradigm — the prevention of HZ. We also apply current opinion and evidence to the management of HZ.

Source: mja.com.au
Clinical Resource: Journal Article
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Last Checked: 13/05/14 Link Error: Report It

 

Royal College of Obstetricians and Gynaecologists Scientific Impact Paper on Periconceptional Folic Acid and Food Fortification in the Prevention of Neural Tube Defects

Source: rcog.org
Clinical Resource: Scientific Impact Paper
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Last Checked: 19/08/15 Link Error: Report It

 

Recommended assessment and treatment of nausea and vomiting

The causes of nausea and vomiting are multifarious and a full clinical history is required before commencing treatment. Our Drug review discusses the diagnosis and the available drug options and their properties, followed by sources of further information.

Source: eu.wiley.com
Clinical Resource: Journal Article
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Last Checked: 16/05/13 Link Error: Report It

 

Guidance for public health management of meningococcal disease in the UK

Management, guidance and control measures from Public Health England’s Meningococcus and Haemophilus Forum

Source: gov.uk
Clinical Resource: Guidance
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Last Checked: 23/02/15 Link Error: Report It

 

Scottish Intercollegiate Guidelines Network (SIGN) Guideline > Management of Invasive Meningococcal Disease in Children and Young People

Source: sign.ac.uk
Clinical Resource: Guideline
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Last Checked: 18/05/15 Link Error: Report It

 

Infectious Diseases Society of America Practice Guidelines for the Management of Bacterial Meningitis

Source: idsociety.org
Clinical Resource: Guideline
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Last Checked: 15/05/15 Link Error: Report It

 

The Management of Encephalitis: Clinical Practice Guidelines by the Infectious Diseases Society of America

Source: idsociety.org
Clinical Resource: Guideline
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Last Checked: 15/05/15 Link Error: Report It

 

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