The primary objective of this narrative review is to evaluate the most frequently recommended structural and functional imaging methods in managing epilepsy cases as effectively as possible from a neurologist’s perspective. This review examines the background of current practice, from the beginnings of neuroimaging by computer tomography to the newly introduced methods and their combination, which helps diagnose and monitor these patients. The neuroimaging investigations required for the presurgical evaluation of patients with epilepsy are presented, and recommendations for specific MRI protocols are provided. The clinical use of functional imaging methods is also considered, and correlations between clinical aspects and specific imaging methods are explored, based on the retrieved data in the literature. In conclusion, this review emphasizes using functional and structural imaging methods, guided by clinical evidence, for better therapeutic management in patients with epilepsy.
This article aims to highlight the burnout burden among neurologists and provide information on some of its causes and consequences. We report an original article that reviews our current understanding of burnout matter in the neurology field. The main search engine through which we performed extensive literature research was PubMed, Scopus, and Google Scholar. The following information was collected: triggers of burnout and factors that perpetuate it, major complaints, values, and goals that dictate how coaching with it. Physician burnout is an umbrella term characterized by symptoms determined by exposure to chronic workplace stressors. Simply put, it encompasses many dimensions: emotional exhaustion, feelings of cynism, detachment (depersonalization), and a sense of ineffectiveness at work (low personal accomplishment). Burnout is common among all medical specialties, but neurology ranks at the top of the list. Several identified factors continue to fuel this problem. Properly addressing them, rethinking practice, and implementing wise, modern strategies can make significant contributions to reducing it. Aside from the chronic harm to the physician, burnout puts at risk the healthcare community at many levels including patients, other professionals, finances, etc. This paper wants to emphasize that burnout in neurology should be regarded as a global crisis. Thus, some strategies are proposed.
Cannabinoids' usefulness in the treatment of neurological disorders (epilepsy, and various neurodegenerative diseases, such as Multiple Sclerosis and Alzheimer's Disease) has been demonstrated in a growing number of studies. Of the 11 known general types of natural cannabinoids, the focus has been mainly directed at cannabidiol (CBD) due to its specificity in stimulating cannabinoid receptors and the low rate of side effects, as well as on Δ (9)-tetrahydrocannabinol (Δ9-THC). The natural and synthetic analogs of CBD have been described as a potential treatment in neurological diseases, as they showed their therapeutic benefits in reducing the seizures from epilepsy and their neuroprotectivity in neurodegenerative diseases. First and foremost, CBD's neuroprotective properties are due to its capacity to act as an endogenous cannabinoid receptor agonist. Second, CBD enhances neuroprotection by interacting with many signal transduction pathways mediated indirectly through cannabinoid receptors. CBD also reduces the hyperphosphorylation of glycogen synthetase kinase 3 (GSK-3) induced by the buildup of Amyloid β in the physiopathology of Alzheimer's disease.
