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Biomedical subjects

J W Norton

Publications and source records attributed to J W Norton.

13 recordsLinked to original sources

Visual perceptual abnormalities: hallucinations and illusions.

Visual perceptual abnormalities may be caused by diverse etiologies which span the fields of psychiatry and neurology. This article reviews the differential diagnosis of visual perceptual abnormalities from both a neurological and a psychiatric perspective. Psychiatric etiologies include mania, depression, substance dependence, and schizophrenia. Common neurological causes include migraine, epilepsy, delirium, dementia, tumor, and stroke. The phenomena of palinopsia, oscillopsia, dysmetropsia, and polyopia among others are also reviewed. A systematic approach to the many causes of illusions and hallucinations may help to achieve an accurate diagnosis, and a more focused evaluation and treatment plan for patients who develop visual perceptual abnormalities. This article provides the practicing neurologist with a practical understanding and approach to patients with these clinical symptoms.

Hallucinations↗

Personality disorders in the primary care setting.

Patients who suffer from personality disorders often exhibit self-destructive behaviors in the clinical setting and are noncompliant. By recognizing the disorder and intervening, primary care providers can help improve patient outcomes and minimize damaging clinical interactions. This article discusses the different types of personality disorders and provides diagnosis, treatment, and referral guidelines.

Humans↗

Intravenous valproate in neuropsychiatry.

Valproic acid (VPA) is administered for a variety of indications in neurology and psychiatry. The intravenous form of VPA, valproate, has been used extensively by neurologists since the 1980s for patients with status epilepticus, as serum levels can be achieved rapidly and telemetry is not required during administration. Psychiatrists have less experience with intravenous valproate, and little is documented in the literature regarding its nonepileptic indications. Patients who are unable or unwilling to take drugs orally, or for whom rapid treatment is clinically indicated, may benefit from VPA. Neuroleptics and benzodiazepines often are given parenterally; however, they may be accompanied by side effects. Intravenous valproate was administered successfully to three patients with neuropsychiatric disorders. It is hoped that this report will increase clinicians' awareness of this important and well-tolerated treatment option.

Adult↗

A nursing-centered treatment team in inpatient medical psychiatry.

1. Nurses have the most extensive direct contact with their patients, yet in the traditional physician-centered model, they are often excluded from decision making. We have developed a new model of patient care with the nurse as the primary therapist and contact person, as well as the individual who cares for each patient's physical needs. 2. Out team approach improves efficiency, integration of care, and staff unity, which can be especially helpful for patients with personality disorders. 3. Patients appreciate the approach and are better able to increase focus on treatment when the physicians are not present in the ward.

Humans↗

Gabapentin withdrawal syndrome.

Gabapentin (GBP) has gained wide acceptance in the treatment of pain, migraine, bipolar illness, and epilepsy. It has a relatively benign side effect profile, lacks significant drug interactions, is not liver metabolized, and is renally excreted. Herein three cases are presented that demonstrate withdrawal symptoms after abrupt discontinuation of GBP. Clinicians are encouraged to taper GBP dosage, especially when patients have taken high doses, and to warn patients of possible adverse effects of abruptly discontinuing GBP themselves.

Acetates↗

Foreign accent-like syndrome during psychotic exacerbations.

OBJECTIVE: The goal of this investigation was to describe the neurologic and psychiatric findings in a patient with foreign accent-like syndrome occurring during episodes of psychotic exacerbation. BACKGROUND: Foreign accent syndrome has been reported in several patients with disorders such as cerebral infarction, cerebral hemorrhage, and head trauma but not in a patient whose primary problem was psychosis. Most patients with this syndrome exhibit some degree of aphasia, and some are dysarthric. METHOD: A schizophrenic patient with foreign accent-like syndrome occurring during a psychotic exacerbation was evaluated by examination and interview, language testing, magnetic resonance imaging, electroencephalography, and other investigative methods. RESULTS: The patient exhibited a prominent British accent, which persisted throughout the duration of his psychotic exacerbation and resolved with improvement of his psychosis. Magnetic resonance imaging revealed no lesions, and no abnormality of language or articulation was present. A single-photon emission computed tomography scan could not be obtained. CONCLUSIONS: This represents the first reported case of a patient with foreign accent-like syndrome during psychotic exacerbations.

Aged↗