Neurology of Systemic Disease

June 2020, Volume 26, Issue 3
BROWSE ISSUES

Neurology of Systemic Disease

June 2020, Vol.26, No.3

Guest Editor:

Joseph E. Safdieh, MD, FAAN

Editor-in-Chief:

STEVEN L. LEWIS, MD, FAAN

ISSN: 1080-2371

Online ISSN: 1538-6899

REVIEW ARTICLES
Cardiac and Pulmonary Disorders and the Nervous System
Weathered, Natalie R.
CONTINUUM: Lifelong Learning in Neurology
June 2020 - Volume 26 - Issue 3, Neurology of Systemic Disease - p 556-576
doi: 10.1212/CON.0000000000000859
Gastrointestinal Disorders and the Nervous System
White, Halina
CONTINUUM: Lifelong Learning in Neurology
June 2020 - Volume 26 - Issue 3, Neurology of Systemic Disease - p 577-590
doi: 10.1212/CON.0000000000000871
Rheumatologic Disorders and the Nervous System
Pavlakis, Pantelis P.
CONTINUUM: Lifelong Learning in Neurology
June 2020 - Volume 26 - Issue 3, Neurology of Systemic Disease - p 591-610
doi: 10.1212/CON.0000000000000856
Obstetric and Gynecologic Disorders and the Nervous System
O’Neal, Mary Angela
CONTINUUM: Lifelong Learning in Neurology
June 2020 - Volume 26 - Issue 3, Neurology of Systemic Disease - p 611-631
doi: 10.1212/CON.0000000000000860
Electrolyte Disorders and the Nervous System
Jacoby, Nuri
CONTINUUM: Lifelong Learning in Neurology
June 2020 - Volume 26 - Issue 3, Neurology of Systemic Disease - p 632-658
doi: 10.1212/CON.0000000000000872
Blood Cell Disorders and the Nervous System
Merkler, Alexander E.
CONTINUUM: Lifelong Learning in Neurology
June 2020 - Volume 26 - Issue 3, Neurology of Systemic Disease - p 659-674
doi: 10.1212/CON.0000000000000858
Critical Medical Illness and the Nervous System
Maas, Matthew B.
CONTINUUM: Lifelong Learning in Neurology
June 2020 - Volume 26 - Issue 3, Neurology of Systemic Disease - p 675-694
doi: 10.1212/CON.0000000000000869
Sarcoidosis and the Nervous System
Pawate, Siddharama
CONTINUUM: Lifelong Learning in Neurology
June 2020 - Volume 26 - Issue 3, Neurology of Systemic Disease - p 695-715
doi: 10.1212/CON.0000000000000855
Commonly Used Drugs for Medical Illness and the Nervous System
Vo, Mary L.
CONTINUUM: Lifelong Learning in Neurology
June 2020 - Volume 26 - Issue 3, Neurology of Systemic Disease - p 716-731
doi: 10.1212/CON.0000000000000854
Anticancer Drugs and the Nervous System
Santomasso, Bianca D.
CONTINUUM: Lifelong Learning in Neurology
June 2020 - Volume 26 - Issue 3, Neurology of Systemic Disease - p 732-764
doi: 10.1212/CON.0000000000000873
Drugs of Abuse and the Nervous System
Stitt, Derek; Kumar, Neeraj
CONTINUUM: Lifelong Learning in Neurology
June 2020 - Volume 26 - Issue 3, Neurology of Systemic Disease - p 765-784
doi: 10.1212/CON.0000000000000857
Editor's Preface
Articles
Key Points
Abbreviations
Appendix
Issue Overview

Issue Overview

CONTINUUM: Lifelong Learning in Neurology June 2020 - Volume 26 - Issue 3, Neurology of Systemic Disease -10.1212/01.CON.0000669632.52803.d0 doi: 10.1212/01.CON.0000669632.52803.d0

Neurology of Systemic Disease, Volume 26, Number 3, June 2020

Continuum: Lifelong Learning in Neurology® is designed to help practicing neurologists stay abreast of advances in the field while simultaneously developing lifelong self-directed learning skills.

Learning Objectives

Upon completion of this Continuum: Lifelong Learning in Neurology Neurology of Systemic Disease issue, participants will be able to:

  • Discuss the neurologic comorbidities and management of endocarditis, cardiac arrest, heart failure, hypercapnia, and cystic fibrosis
  • Discuss the neurologic symptoms that may arise in association with gastrointestinal system and liver conditions
  • Describe the central and peripheral neurologic manifestations of the most common systemic autoimmune diseases
  • Diagnose and manage patients with neurologic syndromes occurring in association with obstetric and gynecologic disorders
  • Discuss the etiologies, neurologic presentations, and treatments of the common electrolyte abnormalities seen in daily neurologic practice
  • Diagnose the neurologic complications of blood cell disorders
  • Describe the neurologic complications that are commonly encountered in patients who are critically ill from medical diseases and list strategies for their diagnosis, prevention, and treatment
  • Diagnose and manage the neurologic manifestations of sarcoidosis (neurosarcoidosis)
  • Discuss the common and serious neurologic side effects associated with commonly prescribed medications
  • Discuss the clinical features, prognosis, and treatment for the broad spectrum of anticancer drug neurotoxicities affecting the central and peripheral nervous systems
  • Describe the wide array of neurologic toxicities associated with substance abuse and the key aspects of their management
  • Describe the different non–face-to-face Evaluation and Management services and list the requirements to properly submit a Current Procedural Terminology or Healthcare Common Procedure Coding System code

Core Competencies

This Continuum: Lifelong Learning in Neurology Neurology of Systemic Disease issue covers the following core competencies:

  • Patient Care
  • Medical Knowledge
  • Practice-Based Learning and Improvement
  • Interpersonal and Communication Skills
  • Professionalism
  • Systems-Based Practice

Contributors

Joseph E. Safdieh, MD, FAAN, Guest Editor

Assistant Dean, Clinical Curriculum; Vice Chair for Education; Lewis and Rachel Rudin Education Scholar; Associate Professor of Neurology, Weill Cornell Medicine, New York, New York

Relationship Disclosure: Dr Safdieh serves as editor-in-chief of Neurology Today, receives publishing royalties from Elsevier, and has provided expert medicolegal testimony on traumatic brain injury.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Safdieh reports no disclosure.

Neil A. Busis, MD, FAAN

Associate Chair of Technology and Innovation; Clinical Professor, Department of Neurology; Clinical Director of Clinical Affairs, Telehealth Program, NYU Langone Health, New York, New York

Relationship Disclosure: Dr Busis serves as an alternate CPT advisor and has received personal compensation for speaking engagements for the American Academy of Neurology.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Busis reports no disclosure.

Luana Ciccarelli, CPC, CRC

Senior Manager, Reimbursement and Coding, Center for Health Policy, American Academy of Neurology, Minneapolis, Minnesota

Relationship Disclosure: Ms Ciccarelli reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Ms Ciccarelli reports no disclosure.

Bruce H. Cohen, MD, FAAN

Director, NeuroDevelopmental Science Center; Interim Vice President and Medical Director, Rebecca D. Considine Research Institute, Akron Children’s Hospital, Akron, Ohio; Professor of Pediatrics, Professor of Integrative and Medical Sciences, Northeast Ohio Medical University, Rootstown, Ohio

Relationship Disclosure: Dr Cohen serves as an associate editor for Continuum, Mitochondrion, and Pediatric Neurology and as the chair of the scientific and medical advisory board of the United Mitochondrial Disease Foundation. Dr Cohen serves as a consultant for Minovia Therapeutics; Modis Therapeutics (Zogenix); NeuroVive Pharmaceutical AB; Reneo Pharmaceuticals, Inc; and the US Department of Health & Human Services and as a CPT consultant for the American Academy of Neurology. Dr Cohen receives research/grant support from BioElectron Technologies (PTC Therapeutics), the National Institutes of Health (U54NS078059), and Stealth BioTherapeutics Inc and publishing royalties from Elsevier and has received personal compensation for speaking engagements from the American Academy of Neurology and Stealth BioTherapeutics Inc.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Cohen reports no disclosure.

Nuri Jacoby, MD

Assistant Professor of Neurology, SUNY Downstate Health Sciences University; Attending Neurologist, Maimonides Medical Center, Brooklyn, New York

Relationship Disclosure: Dr Jacoby has received the Faculty Innovation in Education Award from the American Board of Psychiatry and Neurology.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Jacoby reports no disclosure.

Neeraj Kumar, MD

Professor of Neurology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota

Relationship Disclosure: Dr Kumar reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Kumar reports no disclosure.

Matthew B. Maas, MD, MS, FAAN

Associate Professor of Neurology and Anesthesiology, Northwestern University, Chicago, Illinois

Relationship Disclosure: Dr Maas receives research/grant support from the Agency for Healthcare Research and Quality (R18HS027264), the Davee Foundation, and the National Institutes of Health (K23NS092975).

Unlabeled Use of Products/Investigational Use Disclosure: Dr Maas reports no disclosure.

Alexander E. Merkler, MD

Assistant Professor of Neurology, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York

Relationship Disclosure: Dr Merkler serves on the editorial board of The Neurohospitalist, receives research/grant support from the American Heart Association (18CDA34110419) and the Leon Levy Foundation, and has given expert legal testimony on stroke and neurologic disorders.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Merkler reports no disclosure.

Mary Angela O’Neal, MD

Director of Women’s Neurology; Clinical Director of the Neurosciences, Brigham and Women’s Hospital, Boston, Massachusetts

Relationship Disclosure: Dr O’Neal receives publishing royalties from Oxford University Press and Springer and serves as a consultant for Best Doctors and for CRICO, for which she has provided expert medicolegal testimony in defense of physicians involved in cases of alleged neurologic injury.

Unlabeled Use of Products/Investigational Use Disclosure: Dr O’Neal reports no disclosure.

Pantelis P. Pavlakis, MD, PhD

Assistant Attending, Department of Neurology, Hospital for Special Surgery, New York, New York

Relationship Disclosure: Dr Pavlakis has received personal compensation for completing an online survey from Alexion Pharmaceuticals, Inc.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Pavlakis discusses the unlabeled/investigational use of biologic therapies for the neurologic manifestations of rheumatologic disorders.

Siddharama Pawate, MD

Associate Professor of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee

Relationship Disclosure: Dr Pawate serves on an advisory board for Biogen.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Pawate discusses the unlabeled/investigational use of adalimumab, azathioprine, corticosteroids, cyclophosphamide, infliximab, methotrexate, mycophenolate mofetil, and rituximab for the treatment of neurosarcoidosis.

Bianca D. Santomasso, MD, PhD

Assistant Attending Neurologist, Memorial Sloan Kettering Cancer Center, New York, New York

Relationship Disclosure: Dr Santomasso has served as a consultant for Janssen Pharmaceuticals, Inc; Juno Therapeutics/Celgene Corporation; and Kite Pharma/Gilead Sciences, Inc, and receives research/grant support from ADC Therapeutics SA; the American Cancer Society, Inc; Comedy vs Cancer; the Melanoma Research Alliance; the Parker Institute for Cancer Immunotherapy; and the Society of Memorial Sloan Kettering Cancer Center.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Santomasso discusses the unlabeled/investigational use of anakinra for chimeric antigen receptor T-cell–associated cytokine release syndrome and neurotoxicity and the unlabeled/investigational use of IV immunoglobulin and rituximab for certain severe neurologic immune-related adverse events.

Derek Stitt, MD

Senior Associate Consultant, Division of Neurology Education; Instructor in Neurology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota

Relationship Disclosure: Dr Stitt reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Stitt reports no disclosure.

Mary L. Vo, MD, PharmD

Assistant Professor of Neurology, Weill Cornell Medicine, New York, New York

Relationship Disclosure: Dr Vo has served on the scientific advisory boards of Alexion Pharmaceuticals, Inc, and CSL Behring and as a contractor for Takeda Pharmaceutical Company Limited. Dr Vo has provided expert medicolegal testimony on peripheral neuropathy, myelopathy, and Friedreich ataxia.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Vo reports no disclosure.

Natalie R. Weathered, MD, MS

Assistant Professor of Neurology, Weill Cornell Medicine, New York, New York

Relationship Disclosure: Dr Weathered reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Weathered reports no disclosure.

Halina White, BM BCh, MA, MRCP

Assistant Professor of Clinical Neurology; Director of the Transient Ischemic Attack Clinic, Weill Cornell Medicine, New York, New York

Relationship Disclosure: Dr White reports no disclosure.

Unlabeled Use of Products/Investigational Use Disclosure: Dr White reports no disclosure.

Self-Assessment and CME Test Writers

Adam G. Kelly, MD, FAAN

Associate Professor of Neurology; Director of Teleneurology and Regional Neurology, University of Rochester, Rochester, New York

Relationship Disclosure: Dr Kelly has received personal compensation as CME editor of Neurology.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Kelly reports no disclosure.

Allison L. Weathers, MD, FAAN

Associate Chief Medical Information Officer, Cleveland Clinic; Assistant Professor, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio

Relationship Disclosure: Dr Weathers serves on the editorial board of Continuum and as chair of the adult neurosciences specialty steering board for Epic.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Weathers reports no disclosure.

Methods of Participation and Instructions for Use

Continuum: Lifelong Learning in Neurology® is designed to help practicing neurologists stay abreast of advances in the field while simultaneously developing lifelong self-directed learning skills. In Continuum, the process of absorbing, integrating, and applying the material presented is as important as, if not more important than, the material itself.

The goals of Continuum include disseminating up-to-date information to the practicing neurologist in a lively, interactive format; fostering self-assessment and lifelong study skills; encouraging critical thinking; and, in the final analysis, strengthening and improving patient care.

Each Continuum issue is prepared by distinguished authors who are acknowledged leaders in their respective fields. Six issues are published annually and are composed of review articles, case-based discussions on ethical and practice issues related to the issue topic, coding information, and comprehensive continuing medical education (CME) and self-assessment offerings. For detailed instructions regarding Continuum CME and self-assessment activities, visit continpub.com/CME.

The review articles emphasize clinical issues emerging in the field in recent years. Case reports and vignettes are used liberally, as are tables and illustrations. Audio interviews with the authors of Continuum articles are published alongside each article, and video material relating to the issue topic accompanies issues when applicable.

The text can be reviewed and digested most effectively by establishing a regular schedule of study in the office or at home, either alone or in an interactive group. If subscribers use such regular and perhaps new study habits, Continuum’s goal of establishing lifelong learning patterns can be met.

© 2020 American Academy of Neurology.