Neurologic Disease in Women
http://www.100md.com
《新英格兰医药杂志》
Peter W. Kaplan's second edition of Neurologic Disease in Women reminds the general medical community that the sexes are not created equal. In this age of highly developed medical technology, with gene mapping and advanced therapeutic options hemmed in by the imperatives of health care networks and medical economics to minimize care, this book reminds us that women with neurologic disease deserve special attention. From the beginning, when reproductive hormones determine the sex of a fetus, these same hormones set the stage for later susceptibility to certain diseases that have a sex predilection for women. The expression of reproductive hormones such as estrogen enables women to ensure the lineage of humankind and protects them against chronic illnesses such as stroke and Alzheimer's disease. However, it also makes some women more susceptible to autoimmune and psychiatric disorders, lowers their threshold for seizures, and accelerates the growth of tumors and vascular malformations.
Neurologic Disease in Women presents the physiological, genetic, and anatomical aspects of neurology and gynecology in a clear and concise format that can readily be grasped by general health care providers. The book is divided into three sections. The first section discusses the basic sex-based differences and hormonal effects that contribute to neurologic disorders. The second section focuses on the ever-changing expression of reproductive hormones during different life stages — puberty, the reproductive years, pregnancy, and menopause — and the effect of these hormones on neurologic disorders. Finally, specific neurologic disorders that are more prevalent among women than among men are discussed in detail in the third section.
Any clinician whose patients include women of reproductive age realizes the effect that a chronic disease and its treatment may have on a woman and her childbearing potential. Similarly, the effect of a pregnancy on a neurologic disorder must be considered. This interaction is well considered in this book, because pregnancy is consistently included in the discussions about most neurologic disorders. The importance of informing women about potential risks pertaining to their neurologic disorder and pregnancy is further emphasized in a chapter entitled "Women, Law, and Neurologic Disease." This chapter reminds us that as clinicians caring for these women, we are caring not only for one patient, but for two, and it expounds on the importance of obtaining informed consent regarding the risks of treatment to the woman and her fetus.
The discussion of the effect of menopause on neurologic disorders lacks depth. However, this deficiency may reflect the muddied information on menopause available to the general population. It is hoped that the availability of results of large multicenter studies such as the Study of Women's Health Across the Nation, the Women's Health Initiative, the Heart and Estrogen/Progestin Replacement Study, and the Postmenopausal Estrogen and Progestin Intervention Study will make it possible for future clinical studies to address the effect of menopause and hormone-replacement therapy on neurologic diseases. Perhaps the results of these studies will be ready in time for the third edition of this book.
Teresa A. Tran-Lim, M.D.
MINCEP Epilepsy Care
St. Louis Park, MN 55416
mincepmail@mincep.com(Second edition. Edited by)
Neurologic Disease in Women presents the physiological, genetic, and anatomical aspects of neurology and gynecology in a clear and concise format that can readily be grasped by general health care providers. The book is divided into three sections. The first section discusses the basic sex-based differences and hormonal effects that contribute to neurologic disorders. The second section focuses on the ever-changing expression of reproductive hormones during different life stages — puberty, the reproductive years, pregnancy, and menopause — and the effect of these hormones on neurologic disorders. Finally, specific neurologic disorders that are more prevalent among women than among men are discussed in detail in the third section.
Any clinician whose patients include women of reproductive age realizes the effect that a chronic disease and its treatment may have on a woman and her childbearing potential. Similarly, the effect of a pregnancy on a neurologic disorder must be considered. This interaction is well considered in this book, because pregnancy is consistently included in the discussions about most neurologic disorders. The importance of informing women about potential risks pertaining to their neurologic disorder and pregnancy is further emphasized in a chapter entitled "Women, Law, and Neurologic Disease." This chapter reminds us that as clinicians caring for these women, we are caring not only for one patient, but for two, and it expounds on the importance of obtaining informed consent regarding the risks of treatment to the woman and her fetus.
The discussion of the effect of menopause on neurologic disorders lacks depth. However, this deficiency may reflect the muddied information on menopause available to the general population. It is hoped that the availability of results of large multicenter studies such as the Study of Women's Health Across the Nation, the Women's Health Initiative, the Heart and Estrogen/Progestin Replacement Study, and the Postmenopausal Estrogen and Progestin Intervention Study will make it possible for future clinical studies to address the effect of menopause and hormone-replacement therapy on neurologic diseases. Perhaps the results of these studies will be ready in time for the third edition of this book.
Teresa A. Tran-Lim, M.D.
MINCEP Epilepsy Care
St. Louis Park, MN 55416
mincepmail@mincep.com(Second edition. Edited by)