Patient Care Neurology & Psychiatry - November 2007 - (Page 2)

Research Digest Women with dementia lose weight long before diagnosis Dementia in women is characterized by a steady loss of weight that begins years before the condition is diagnosed. Researchers at the Mayo Clinic in Rochester, Minn, used records from the Rochester Epidemiology Project to match 295 dementia patients (219 women and 76 men, diagnosed between 1990 and 1994) with an equal number of controls. The weight of subjects and their matched controls were determined to be the same at 21 and 30 years prior to the onset of dementia. In the decade preceding diagnosis, women with dementia showed a median weight loss of 8 lb, compared to a 2-lb median weight loss among their matched controls. Age at onset of dementia was not a factor. Evidence of the difference in weight loss between dementia patients and controls was observed up to 20 years prior to diagnosis but not before that. The degree of difference increased over time. The study found no evidence of weight loss associated with dementia in men. The study’s authors suggest a number of social and physiologic factors that might explain their findings, including “predementia apathy, loss of initiative, and reduced olfactory function.” Knopman DS, Edland SD, Cha RH, et al. Incident dementia in women is preceded by weight loss by at least a decade. Neurology. 2007;69(8):739-746. A quick summary of recent reports from leading medical journals Epilepsy patients with aura may benefit from surgery Patients with partial epilepsy who experience multiple auras during epileptic seizures are good candidates for surgical intervention. Investigators evaluated 31 patients with partial epilepsy who had experienced multiple aura types (abdominal, auditory, autonomic, gustatory, olfactory, psychic, somatosensory, and visual) during a seizure. The majority of patients in the study experienced localized seizures originating from the nondominant brain hemisphere. Resective epilepsy surgery was performed in 19 patients. Following the procedure, 10 (53%) were seizure-free. “Most patients who report multiple aura types have localized epilepsy in the nondominant hemisphere and are good surgical candidates,” the authors conclude. Widdess-Walsh P, Kotagal P, Jeha L, et al. Multiple auras: clinical significance and pathophysiology. Neurology. 2007;69(8): 755-761. Zolmitriptan nasal spray relieves cluster headaches Zolmitriptan nasal spray safely relieves cluster headaches. Researchers compared the effect of 5 and 10 mg of zolmitriptan nasal spray versus placebo on headache intensity in 52 adults experiencing 151 headache attacks. The researchers found that zolmitriptan, 10 mg, gave significant relief within half an hour in 63.3% of cases, while 5 mg provided significant relief in 50% of cases, and placebo relieved only 30% of cases. After 10 minutes, zolmitriptan, 10 mg, relieved headaches better than placebo and worked better than placebo at achieving a pain-free state. Sixteen percent of participants on placebo experienced side effects compared to 25% on zolmitriptan, 5 mg, and 32.7% on 10 mg. Rapoport AM, Mathew NT, Silberstein SD, et al. Zolmitriptan nasal spray in the acute treatment of cluster headache: a doubleblind study. Neurology. 2007;69(9):821-826. For more medical news that matters to primary care, please see Medicine in the News, page 7, and Clinical Clips, page 26. Research Digest is prepared by the editors of Patient Care and HealthDay’s Physician’s Briefing (http://www.physiciansbriefing.com). 2 PATIENT CARE NEUROLOGY & PSYCHIATRY www.patientcareonline.com http://www.physiciansbriefing.com http://www.patientcareonline.com

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Patient Care Neurology & Psychiatry - November 2007 Contents Research Digest Medicine in the News The 15-Minute Visit Dementia workup and treatment: Do the drugs really work? Help for Your Patients Who Suffer from Specific Phobias Clinical Clips Case & Comment The Science of Healing Classified Advertising

Patient Care Neurology & Psychiatry - November 2007

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