bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cranial And Spinal Nerve Overview
Authors: Fisch Adam 
Published: November 2023

Abstract
In This Chapter, we will learn the organization of the cranial and spinal nerves. In order to do so, we will first review the embryogenesis of cranial and spinal nerve development, which will require us to establish the anatomical landscape of the developing embryo. This approach requires extra work at the outset and, therefore, is often met with resistance. However, bear with this teaching method. Knowing the embryogenesis of these nerve groups will allow us to infer their anatomical positions and functions, long after we forget them. Moreover, the information we learn here about the neural plate and folding of the neural tube is of great clinical importance, and is a common board topic in its own right. At the end of the chapter, the highlights of this material are simplified and consolidated for use at the bedside. We must know the global topography of the cranial nuclei to practice neurology; the rest of the details are secondary.
Somatomotor Cranial Nerves
Authors: Fisch Adam 
Published: November 2023

Abstract
The Somatomotor Cranial nerves comprise cranial nerves 3, 4, 6, 12, and 11. It is called “somatomotor” because these nerves innervate somite muscle derivatives. All of the somatomotor cranial nerves originate in midline and innervate midline musculature, and they are all general somatomotor nerves, except for cranial nerve 3, which has an additional general visceral motor cell column component. We discuss the visceral component of cranial nerve 3, the Edinger–Westphal nucleus, in the “Eye Movements” chapter in association with the pupillary light reflex.
White Matter Pathways
Authors: Fisch Adam 
Published: November 2023

Abstract
White Matter Pathways are the train-tracks of the nervous system. If they are interrupted, impulses stagnate. Historically, the number of publications on white matter has paled in comparison to that on gray matter. However, now, with diffusion tensor imaging and other radiographic techniques dedicated to imaging the white matter pathways, much is being learned about their anatomy. Recent attempts to clarify white matter anatomy using audiographic and diffusion spectrum imaging techniques were compiled in a remarkable book entitled Fiber Pathways of the Brain, by Jeremy Schmahmann and Deepak Pandya. Images from that book are included at the start of this chapter.
Olfactory System
Authors: Fisch Adam 
Published: November 2023

Abstract
The Olfactory System is a less important sensory system in humans than in many other animal classes but its anatomy has been well studied and, as discussed in the preceding chapter, it has important secondary connections to memory and behavioral brain regions. In Parkinson’s disease and Alzheimer’s dementia, loss of olfactory function is an early symptom of disease, and research is ongoing to use olfactory testing to help diagnose these clinical disorders in their early stages.
Apraxia
Authors: Fisch Adam 
Published: November 2023

Abstract
Apraxias Are notoriously difficult to conceptualize and, unfortunately, inconsistently defined throughout the literature. In some ways trying to imagine them is like looking at a three-dimensional painting: let your mind go and the image will become clear, but if you focus on any particular element within it, the image will fragment into numerous, insubstantial pieces. In this chapter, we will first establish the common definitions of frequently discussed apraxias, so we will be able to look for them at the bedside and answer board questions about them. Then, we will disassemble these definitions in order to understand their limitations. If you just want a simple mental construct for the apraxias, it is better to accept the imaginary, three-dimensional painting than to analyze its fragments; however, to do so, you need to accept that what you are viewing is unreal.
Etiology of Parkinson’s disease
Authors: Dalvi Arif , Walsh Ryan 
Published: November 2023

Abstract
Sir James Parkinson considered “indulgence in spirituous liquors” and “long lying on the damp ground” as possible etiologies of Parkinson’s disease (PD).1 Eighty years later, Gower reported that 15% of his patients with PD had a family history.2 More recently, initial impressions from a twin study on World War II veterans suggested a minor role for genetic factors, as similar concordance rates were observed in monozygotic and dizygotic twins.3 However, following the discovery of the α-synuclein gene4 and the subsequent discovery of a number of PARK genes, the debate between supporters of genetic or environmental causes has been renewed. The assumptions of Sir James Parkinson have not held up, but a number of alternative environmental factors have been brought into the limelight. This review is focused on “idiopathic” PD, although causes of atypical parkinsonism are reviewed where they offer relevant insights. Current understanding of the etiology of PD points to a multifactorial disorder with gene–environment interactions leading to neuronal cell death (Fig. 5.1).
Management of motor disability in advanced Parkinson’s disease
Authors: Lyons Kelly E , Pahwa Rajesh 
Published: November 2023

Abstract
Parkinson’s disease (PD) is a progressive neurodegenerative disorder with increasing disability as the disease progresses. Motor disability in advanced disease can be related to either complications of antiparkinsonian therapy or to the progression of the disease. Motor complications related to levodopa therapy include motor fluctuations and dyskinesia. Disease progression often results in the development of postural instability and freezing.1
Nonpharmacological management of Parkinson’s disease
Authors: Videnovic Aleksandar 
Published: November 2023

Abstract
Parkinson’s disease (PD) is a progressive neurodegenerative disorder associated with significant disability in both motor and nonmotor functional domains. Pharmacological and surgical treatments have significantly improved the symptomatic burden of PD. However, due to the progressive nature of PD, these therapies often become ineffective with time, and may cause intolerable adverse events. There is therefore a tremendous need to optimize the utilization of nonpharmacological rehabilitative therapies with the aim of improving function and quality of life in the PD population. This chapter summarizes the role of nonpharmacological therapies in the management of PD patients.
Parkinson’s Disease Treatment Guide for Physicians
Authors: Ahlskog J Eric 
Published: November 2023

Abstract
Roughly 1.9 million people are afflicted with Parkinson’s disease and, according to the Parkinson’s Disease Foundation, that number is on the rise! Parkinson’s Disease Treatment Guide for Physicians will comprehensively cover Parkinson’s disease (PD), including diagnosis, testing, prognosis, and possible causes. Its primary focus will be on treatment, specifying appropriate drugs, doses, and common side effects. It will address not only the treatment of motor problems (tremor, gait, etc.), but everything else that routinely arises in a PD practice, including osteoporosis prevention, blood pressure, sexual, bowel, or bladder dysfunction, dementia, depression, common skin rashes, and more. This book will mirror Dr. Ahlskog’s earlier book, The Parkinson’s Treatment Book: Partnering with Your Doctor to Get the Most from Your Medications (2005). Each chapter in the current book will follow the same outline and cover nearly the same material as in each chapter of the earlier patient book, but it will be more succint and direct, with many teaching points summarized wtih bullet points or in small tables. In effect, the clinician and patient can both be reading, or have read, the same material.
Parkinsonism-Plus Syndromes, Levodopa Failures, and Refractory Tremor: Treatment Options
Authors: Ahlskog J Eric 
Published: November 2023

Abstract
In chapter 6, we discussed a number of disorders that may masquerade as Parkinson’s disease (PD) but have other origins. This includes the so-called parkinsonism-plus syndromes. Sometimes, these conditions are not recognized until they fail levodopa treatment. In this chapter, we will address what medications are available for these conditions, as well as levodopa-refractory tremor.
Levodopa Adjustments to Treat Motor Instability: Motor Fluctuations and Dyskinesias
Authors: Ahlskog J Eric 
Published: November 2023

Abstract
The progressive loss of nigrostriatal dopaminergic terminals ultimately results in altered levodopa pharmacodynamics, as discussed in chapters 5 and 10–12. The initial stable levodopa benefit, termed the “long-duration response,” begins to give way to responses increasingly tied to each dose, the so-called “short-duration response.” During the initial treatment years when long duration responses predominate, the timing of the doses is not important, except for taking them without food; doses can be missed without a decline in benefit. However, after several years or longer, the benefit begins to fluctuate; the response develops within an hour or so after each dose, persists for a few hours or less, and then declines. This concept is graphically depicted in figure 17.1. Occasional patients with long-standing Parkinson’s disease (PD) will experience responses lasting only 1–2 hours, which mirrors the plasma levodopa half-life of 1.5–2 hours.
Insomnia, Somnolence, and Other Sleep Disorders
Authors: Ahlskog J Eric 
Published: November 2023

Abstract
Insomnia is a major problem for many with Parkinson’s disease (PD) and the most common cause is nocturnal parkinsonism. Untreated or undertreated parkinsonism is associated with a variety of symptoms that prevent PD patients from becoming comfortable in bed, such as akathisia, stiffness, difficulty in turning over, tremor, and dystonic cramping. Obviously, insomnia is common in the general population and other nonparkinsonism-related factors may also be operative in PD. However, clinical experience suggests that the majority of PD patients with insomnia have parkinsonism as the primary cause.
Constipation and Delayed Gastric Emptying
Authors: Ahlskog J Eric 
Published: November 2023

Abstract
The autonomic nervous system is affected early in Parkinson’s disease (PD) and this especially includes the gastrointestinal (GI) myenteric plexuses, as well as autonomic spinal neurons. As a consequence, GI motility is impaired, with slowed transit and consequent constipation and delayed gastric emptying. In fact, constipation may be one of the earliest symptoms, predating the motor symptoms of PD by a decade.
Societal and Occupational Issues; Caregivers
Authors: Ahlskog J Eric 
Published: November 2023

Abstract
The clinician is an invaluable resource not only to the patient with Parkinson’s disease (PD), but also to the family. As an ally in the battle against PD, the clinician’s advice may be sought when confronting certain life-altering decisions. These decisions obviously must be individualized, and we will discuss only general principles. However, it all starts with the primary treatment goal that has been reiterated many times in the book: The goal of the clinician is to do everything possible to maintain patients in the mainstreams of their lives, including optimum use of PD medications. However, if and when insurmountable problems surface, life changes may be necessary.
Factors Involved in Causing Multiple Sclerosis
Authors: Birnbaum Gary 
Published: November 2023

Abstract
MS occurs worldwide, but its incidence varies greatly. MS is most common in temperate climates, both above and below the equator, with diminishing frequency as one approaches the equator. The reasons for this uneven distribution are not clear, but one important factor must be environmental exposure. There are major differences in exposures to viral, bacterial, and parasitic agents in different geographic areas, as well as differences in the ages at which individuals are exposed to these agents. Migration studies of populations moving from higher-risk to lower-risk regions, or vice versa, have convincingly shown that living in a particular risk area before puberty establishes the risk for that individual; moving subsequently does not change the risk. Thus, an early environmental event, possibly infectious, is important in determining susceptibility to disease. Many factors have been implicated; among them are exposure to Epstein-Barr virus and exposure to, or lack of exposure to, sunlight and vitamin D.
Complementary Therapies for Multiple Sclerosis
Authors: Birnbaum Gary 
Published: November 2023

Abstract
Providing truly comprehensive care to persons with MS requires the services of health professionals other than physicians. There are multiple aspects of disease management that cannot be addressed as part of an individual’s visit to the physician’s office, and these additional aspects of disease management are the subject of this chapter. Individual needs will vary greatly depending on the phase of the person’s illness (e.g., newly diagnosed, or entering the secondary-progressive phase of their disease), their degree of disability, and the support available from family and friends. Availability of services and financial resources also vary greatly, potentially putting more burden on caregivers and necessitating compromises. In an ideal world, all services described below would be readily available, easily accessed, and financially feasible.
How the Physician’s Ethics and Goals Determine the Content and Techniques of the Clinical History
Authors: DeMyer William E 
Published: November 2023

Abstract
The ethical code of the medical model (Table 4–1) requires the physician to act always for the patient’s benefit (Wynia et al., 1999). This key ethic is the foundation for the entire the physician–patient relationship (Li, 1996). Most of the major medical organizations worldwide and most ethicists either explicitly accept this ethic and the derivative ethics listed in Table 4–1 or do not contradict them (Ahronheim et al., 2000; Beauchamp and Walters, 2003; Bernat, 2002; Hope, 2004; Weinberg, 2000).
Ending the Clinical History, Recording It, and Integrating It with the Physical Examination
Authors: DeMyer William E 
Published: November 2023

Abstract
The first question is “What do you think may have caused your symptoms?” or “Are you worried about any particular disease causing your symptoms?” Such questions may disclose fears of specific disorders such as cancer, heart disease, and AIDS. The patient’s symptoms may imitate those of a relative or friend who died of these diseases. From the patient’s answers, you plan a workup that will exclude the feared disease, or you will know how best to present the unwelcome news if the patient has the feared disease (Creagan, 1994). I had a compelling experience with the father of the next patient. Pt 30: The parents brought their 3-year-old son to the Riley Hospital emergency room because he had just had a brief febrile convulsion. As the father narrated the history, his voice quavered and his hands shook visibly. Convulsions in a child always upset parents, but the father’s reaction far exceeded the usual. I stopped the progression of questions and said, “I see that something has made you extremely upset. Can you tell me about it?” He said, “When I was 9 years old, I had a puppy that had convulsions, and he died one day, in my arms, having a convulsion.”
The Clinical History of the Medical Model Compared to Alternative Models
Authors: DeMyer William E 
Published: November 2023

Abstract
Why practitioners of alternative medicine cannot use the history and thought processes of the medical model By design, the clinical history discloses symptoms that relate to a scientific understanding of brain and body functions and disease. The clinical history searches for scientifically verifiable causes of disease, such as exposure to microbes or toxins, heredity, autoimmune reactions, and stress. Beyond the science, the art of the clinical history explores the essence of the patient. Because alternative practitioners reject scientific explanations of causality and pathogenesis, they couch their histories in terms that sell their belief system and their products.
Fostering Empathy and Compassion
Authors: DeMyer William E 
Published: November 2023

Abstract
Yes, beyond the mask and the daily costume we wear resides a sentient being, a vortex, always hoping, striving, yearning, and finally surrendering a last breath. To discover what’s behind the patient’s mask, the best physicians listen skillfully and display warmth, modesty, humility, and grace. They compassionately, nonjudgmentally accept every patient (Stevenson, 1971). They shift from a doctor-centered catalogue of symptoms to a patient-centered interview that explores the patient’s reactions, feelings, and values to pursue concerns rather than simply complaints (see Chapter 6). Beyond analysis of the symptoms, the history aims at empathy, compassion, and trust. Empathy means to understand the patient’s feelings and perspectives and to communicate that understanding to the patient. Without empathy and compassion, we just turn out robots who can do procedures or tie surgical knots but cannot act as physicians (Adson, 1995; Benbassat and Baumal, 2004; Coulehan et al., 2001; Crawshaw, 2002; Tauber, 2006).
Stories
Authors: Fischer John Martin 
Published: November 2023

Abstract
Recently, at a conference in California, Professor Jules Levain (University of Paris) gave an interesting talk on the relationship between virtue and community. More specifically, he wished to distinguish various claims about the relationship between virtue and community and to evaluate some of them. Two particularly salient claims discussed by Levain were that community sustains virtue and that community gives content to virtue. That is to say, Levain wished (among other things) to evaluate the claims that certain sorts of communities perform crucial and indispensable sustaining and content-providing functions for various virtues.
Family, Rectirement, and Old Age
Authors: Laureno Robert 
Published: November 2023

Abstract
In 1944 Ray and Elinor Adams bought a decrepit old New England farm house in Milton, Massachusetts. They borrowed the money from Ray’s mother to make the purchase. He couldn’t afford to have it painted. For a year before they moved in, Ray’s father and Ray worked to repair the structure. Three years later he bought the adjacent field with a loan from his mother. Eventually, their son recalls, they had 4 or 5 acres, 1½ acres of which was their vegetable garden. Everything that they ate was grown by Elinor who canned and froze the foods. The neighboring acres were vacant and provided more room for recreation including baseball games at neurology picnics. The Adams grandparents, both of whom survived into their eighties, lived in the vast home. Ray’s father was growing demented. Eventually his door was locked at night to avoid any incident.
Tracing a Ghostly Memory in My Throat: Refl ections on Ftm Feminist Voice and Agency
Authors: Hale C Jacob 
Published: November 2023

Abstract
It is from all those who have abandoned the traditional conception of sexual morality that the transsexuals differ. Unlike militant homophiles, enlightened therapists and liberated women, transsexuals endorse such traditional values as heterosexuality, domestic roles for women, the double standard of sexual morality, the traditional division of tasks and responsibilities, and the discreditation of deviant sexuality. Unlike various liberated groups, transsexuals are reactionary, moving back toward the core-culture rather than away from it. They are the Uncle Toms of the sexual revolution.
Introduction
Authors: Slote Michael 
Published: November 2023

Abstract
The present volume contains a selection from among papers and reviews that I have published and papers that I haven’t previously published. The principle of selection has been my sense of the interest papers might hold for contemporary discussion. Some of these papers were published around forty years ago, and others that I have chosen not to reprint were also published (at least) that long ago, so I have had to be choosy in my selection—at least I hope that I have been. I would like here to introduce the papers that appear in this book. In some cases I shall compare them with other people’s ideas/publications; in others I shall indicate how I think they might be further developed in contemporary terms; in still others I make what I hope are useful comparisons among the essays that appear in this volume. Again, my choice of what to say in this Introduction has been determined by my sense of what might be useful to contemporary philosophy or philosophers. And let me just mention before I begin that the order in which the papers appear in this book and are discussed in this Introduction is (roughly) chronological.
The Theory of Important Criteria
Authors: Slote Michael 
Published: November 2023

Abstract
Consider the following questions: can a promise be kept by accident? is philosophical doubt really doubt? is a nation that has majority rule but no minority rights a democracy? is the whale a fish? is Buffalo really a city? are tables and chairs ever solid? All these questions either are philosophical or closely resemble philosophical questions in the way they are argued about by both philosophers and nonphilosophers without seeming ever to be definitively resolved. In recent years some notable theories have been put forward to explain disagreements over questions of this sort. Most of these theories seek to explain the existence and persistence of such disagreements in terms of two, or more, meanings of the term whose applicability is in question.
Time in Counterfactuals
Authors: Slote Michael 
Published: November 2023

Abstract
I would like to offer an account of counterfactuals that is strikingly at variance with the presently dominant Stalnaker-Lewis “similarity” theory of counterfactuals, that is something of a throwback to Goodmanlike “cotenability” treatments of counterfactuals, but that differs from Goodman’s conception in putting a special emphasis on temporal distinctions and directions. I shall begin by arguing for and illustrating the importance of two sorts of time reference in the truth conditions of counterfactuals. Thereafter, I shall attempt to show that the role of time in counterfactuals is most readily accommodated by a cotenability framework for counterfactuals, and shall offer a version of cotenability theory that avoids the circularity and some of the counterexamples that afflict earlier forms of the theory. The new version makes distinctive use of the concept of explanation both in explicating the notion of cotenability and in specifying the relation that holds between the antecedent and consequent of true counterfactuals (in English). Towards the end of the paper, I shall discuss the advantages this form of cotenability theory seems to have over current versions of similarity theory.
Assertion and Belief
Authors: Slote Michael 
Published: November 2023

Abstract
This talk will have its messy aspects: I simply haven’t been able to form a clear picture of all the phenomena I would like to speak to you about. In any event, the phenomena of belief and assertion I shall be dealing with are perhaps themselves simply messier and more confusing than one would initially suspect. And I hope to be able to make at least this much clear to you.
Selective Necessity and the Free-Will Problem
Authors: Slote Michael 
Published: November 2023

Abstract
Anew form of argument for the incompatibility of free will and determinism has recently become prevalent. Carl Ginet, James Lamb, Peter van Inwagen, and David Wiggins have all mounted attacks on compatibilism which take inspiration from the fact that nothing can now be done about events in the (remote) past. Unlike older discussions that seem to hinge on the assumption of universal causation alone, these new arguments do not make the mistake of assuming that, since all actions in a deterministic universe are necessitated by past events taken together with (necessary) laws of nature, all our actions are themselves necessary (inevitable, unavoidable) if determinism is true.