Behavioral Neurology and Neuropsychiatry

June 2015, Volume 21, Issue 3
BROWSE ISSUES

Behavioral Neurology and Neuropsychiatry

June 2015, Vol.21, No.3

Guest Editor:

Joseph S. Kass, MD, JD

Editor-in-Chief:

ISSN: 1080-2371

Online ISSN: 1538-6899

REVIEW ARTICLES
Neurobehavioral Assessment
Kaufer, Daniel I.
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 597-612
doi: 10.1212/01.CON.0000466655.51790.2f
Memory Dysfunction
Matthews, Brandy R.
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 613-626
doi: 10.1212/01.CON.0000466656.59413.29
Language Dysfunction
Gill, David J.; Damann, Krista M.
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 627-645
doi: 10.1212/01.CON.0000466657.97531.af
Executive Dysfunction
Rabinovici, Gil D.; Stephens, Melanie L.; Possin, Katherine L.
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 646-659
doi: 10.1212/01.CON.0000466658.05156.54
Dysfunction of Social Cognition and Behavior
Dickerson, Bradford C.
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 660-677
doi: 10.1212/01.CON.0000466659.05156.1d
Perceptual-Motor Dysfunction
Finney, Glen R.
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 678-689
doi: 10.1212/01.CON.0000466660.82284.69
Neurodevelopmental Behavioral and Cognitive Disorders
Jeste, Shafali Spurling
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 690-714
doi: 10.1212/01.CON.0000466661.89908.3c
Psychosis
Arciniegas, David B.
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 715-736
doi: 10.1212/01.CON.0000466662.89908.e7
Mania
Dubovsky, Steven L.
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 737-755
doi: 10.1212/01.CON.0000466663.28026.6f
Depression
Schulz, Paul E.; Arora, Garima
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 756-771
doi: 10.1212/01.CON.0000466664.35650.b4
Anxiety
Shah, Asim A.; Han, Jin Y.
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 772-782
doi: 10.1212/01.CON.0000466665.12779.dc
Obsessive-Compulsive Disorder
Drubach, Daniel A.
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 783-788
doi: 10.1212/01.CON.0000466666.12779.07
Posttraumatic Stress Disorder
Jorge, Ricardo E.
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 789-805
doi: 10.1212/01.CON.0000466667.20403.b1
Personality Disorders
Newlin, Elizabeth; Weinstein, Benjamin
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 806-817
doi: 10.1212/01.CON.0000466668.02477.0c
Functional Neurologic Disorders
Stone, Jon; Carson, Alan
CONTINUUM: Lifelong Learning in Neurology
June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry - p 818-837
doi: 10.1212/01.CON.0000466669.02477.45
Editor's Preface
Articles
Key Points
Abbreviations
Appendix
Issue Overview

Editor-in-Chief:

Totally Psyched

CONTINUUM: Lifelong Learning in Neurology June 2015 - Volume 21 - Issue 3, Behavioral Neurology and Neuropsychiatry -p 595-596 doi: 10.1212/01.CON.0000466654.51790.66

I would like to sincerely thank Dr Kass and his professionally diverse group of remarkably expert authors for creating such a comprehensive and up-to-date volume to thoroughly inform our approach to our many patients with neuropsychiatric, neurobehavioral, and psychiatric disorders.

This issue of CONTNUUM arose out of the curricular plan to include as much of the totality of psychiatry, behavioral neurology, and neuropsychiatry of relevance to the practice of clinical neurology as is possible within each 3-year CONTNUUM cycle. I was therefore thrilled (ie, completely psyched) when Joseph S. Kass, MD, JD, a member of the CONTNUUM editorial board and associate professor in the Department of Neurology as well as the Menninger Department of Psychiatry and Behavioral Science at Baylor College of Medicine, accepted my invitation to be the guest editor of this very ambitious issue. Dr Kass has succeeded in bringing together a remarkably diverse faculty—including neurologists, psychiatrists, neuropsychiatrists, and neuropsychologists—to provide us with a thorough, clinically relevant, and up-to-date review of primary psychiatric disorders, the neurology of behavior and cognition, as well as the interface between neurologic and psychiatric disorders, to help us as we encounter these disorders in our day-to-day practice of clinical neurology.

This issue essentially consists of two sections. The first half of the issue is devoted to behavioral neurology. The articles in the second half of the issue primarily tackle the primary psychiatric disorders; however, these articles also cover the important interface between the psychiatric syndromes and neurologic disease as relevant to the topics at hand. Readers should also note that the pathophysiology, diagnosis, and management of the specific neurodegenerative diseases that cause dementia will be covered in great detail in the upcoming CONTNUUM issue on dementia that will be published in April 2016.

This issue begins with a thorough overview of neurobehavioral assessment by Dr Daniel I. Kaufer, serving as an introduction to the subsequent articles in this section and providing all of us neurologists with a very practical approach to use in our clinical cognitive and behavioral assessments of our patients with neurobehavioral disorders. Next, Dr Brandy R. Matthews carefully delineates the three major memory systems of episodic, semantic, and procedural memory, including their neuroanatomic substrates and bedside clinical assessment, and describes the major representative disorders characterized by memory dysfunction in each of these three domains. Drs David J. Gill and Krista M. Damann then provide a thorough review of the current concepts of language function and dysfunction and their neuroanatomic correlates, review the syndromes and presentations of the major disorders affecting language, and provide a step-by-step description of the techniques we can all use in our bedside assessment of language and for diagnosis of these disorders.

Drs Gil D. Rabinovici, Melanie L. Stephens, and Katherine L. Possin then review the most current concepts relating to executive dysfunction, including delineation of the four distinct components of executive function (working memory, inhibition, set shifting, and fluency), the neuroanatomy underlying these functions, and the clinical approach to and differential diagnosis of patients with disorders affecting executive function. Dr Bradford C. Dickerson next reviews the neural systems and regions that are now increasingly being understood as critical to social cognition and behavior and discusses disorders of social cognition with special attention to frontotemporal dementia, the prototypical disorder of great relevance to neurologists, including its presentation, clinical assessment, and differential diagnosis. Dr Glen R. Finney informs us about the high-level neurologic processes underlying disorders of perceptual-motor function such as apraxias, agnosias, and Balint syndrome, explains their neuroanatomic underpinnings, and provides very clear descriptions of their presentations and bedside clinical assessment. Dr Shafali Spurling Jeste next provides us with a state-of-the-art review of the clinical presentation, diagnosis, and management of the major neurodevelopmental disorders that arise in childhood, including attention deficit hyperactivity disorder, autism spectrum disorder, global developmental delay, and intellectual disability, while also informing us of the important issues that arise in patients with each of these disorders related to their transition to adulthood.

Next come the group of articles tackling major psychiatric disorders, starting with psychosis, where Dr David B. Arciniegas provides us with a detailed discussion and update on the most current definitions and approaches to the diagnosis, evaluation, and management of primary and secondary psychoses. Similarly, the following article by Dr Steven L. Dubovsky covers the definition of mania and other manic syndromes while also detailing the diagnosis, pathophysiology, treatment, and course of bipolar disorder, as well as mania occurring in association with neurologic disease or as a complication of the treatment of neurologic disease. Drs Paul E. Schulz and Garima Arora then clearly and concisely review current diagnostic criteria, differential diagnosis, and management of depression as a symptom of a primary psychiatric disorder while also reminding us that depression can be the presenting symptom of neurologic disease; they also discuss clues to help us clarify when depression may be a presenting symptom of a neurocognitive disorder. Drs Asim A. Shah and Jin Y. Han then provide an overview of the anxiety disorders, including their most current classification scheme and the diagnosis (including some helpful “diagnostic key words” to assist us as we take our patients’ histories) and management of these symptoms. Dr Daniel A. Drubach provides a succinct review of obsessive-compulsive disorder as a primary psychiatric disease and as a complication of neurologic disease, updating us on the neurobiology, clinical features, and management of this disorder. Dr Ricardo E. Jorge next offers a thorough review and update on the definition, epidemiology, pathophysiology, and contemporary diagnostic assessment and management of posttraumatic stress disorder, a disorder that, as the author notes, has a lifetime prevalence of close to 10% and of which, therefore, all neurologists should be aware. Drs Elizabeth Newlin and Benjamin Weinstein review the personality disorders, including their most current classification and diagnostic criteria as well as their clinical features, epidemiology, and management, placing emphasis on the need for compassion when dealing with patients with these disorders, which are common in any clinical practice.

Finally, Drs Jon Stone and Alan Carson discuss the current terminology, classification, pathophysiologic mechanisms, and diagnosis of functional neurologic disorders (where they emphasize the importance of positive diagnosis based on clinical features rather than just excluding other diseases or relying on the presence of psychological features) and also review their approach to effective management of these conditions.

In this issue’s Practice article, Dr Edward Poa and Dr Kass present and discuss two representative cases to provide us with an extremely practical and concise review of the considerations involved in managing outpatients with suicidal or homicidal ideation. Drs Joseph V. Fritz, Jennifer McVige, and Laszlo Mechtler review the many considerations involved in coding for the various encounters and diagnoses that can arise in the context of patients with disorders falling into the broad categories of behavioral neurology and neuropsychiatry.

As with every issue of CONTNUUM, a number of opportunities exist for CME. By taking the Postreading Self-Assessment and CME Test, written by Drs Ronnie Bergen and James Owens (and including several questions on neuropsychological testing that were crafted by Dr Melanie L. Stephens), after reading the issue, you may earn up to 12 AMA PRA Category 1 Credits™ toward self-assessment and CME. The Patient Management Problem, carefully and expertly written by Dr Kass, follows the case of a 67-year-old woman who presents to the neurology clinic with symptoms of a mood disorder and possible cognitive dysfunction. By following her case and answering multiple-choice questions corresponding to diagnostic and management decision points along the course of her disorder, you will have the opportunity to earn up to 2 AMA PRA Category 1 CME Credits.

I would like to sincerely thank Dr Kass and his professionally diverse group of remarkably expert authors for creating such a comprehensive and up-to-date volume to thoroughly inform our approach to our many patients with neuropsychiatric, neurobehavioral, and psychiatric disorders.

—Steven L. Lewis, MD, FAAN

Editor-in-Chief

© 2015 American Academy of Neurology