FRIDAY, March 8 (HealthDay News) -- Five tests, procedures and
treatments that neurologists and their patients should question are
outlined in a list released by the American Academy of Neurology
(AAN) as part of the Choosing Wisely campaign.
"With one in six people affected by a brain disease, such as
headache, multiple sclerosis and stroke, our goal is to have
patients discuss our Choosing Wisely recommendations regarding
medical procedures, therapies, and tests with their neurologists,"
AAN president Dr. Bruce Sigsbee said in an academy news
The American Board of Internal Medicine Foundation-led Choosing
Wisely campaign involves about 35 medical specialty groups and is
intended to encourage patients and doctors to discuss appropriate
care while avoiding unnecessary tests and treatments. The AAN is
one of 17 medical societies that recently released advice
Here are the AAN's five neurology-related recommendations: Do not perform electroencephalography (EEG) for headaches.
Recurrent headache, which is the most common pain problem, affects
up to 20 percent of people. EEG increases costs but has no
advantage over clinical evaluation in diagnosing headache and it
does not improve outcomes.Do not perform imaging of the carotid arteries in the neck for
simple fainting in the absence of other neurologic symptoms.
Fainting affects up to 40 percent of people during their lifetime.
Carotid artery disease does not cause fainting; rather, it causes
focused neurologic problems such as weakness on one side of the
body. Therefore, carotid imaging will not identify the cause of the
fainting, but it does increase costs.When treating migraine, opioid or butalbital drugs should only
be used as a last resort. More effective, migraine-specific
treatments are available, and frequent use of these drugs can
worsen headaches. Opioid (narcotic) use should be reserved for
patients with medical conditions that prevent the use of
migraine-specific treatments or for patients for whom these
treatments don't work.Do not prescribe interferon-beta or glatiramer acetate to
patients with disability from progressive, non-relapsing forms of
multiple sclerosis. These medications, often prescribed for MS, do
not prevent the development of permanent disability in progressive
forms of the disease. However, they do have frequent side effects
that may negatively affect quality of life, and increase costs as
well.Do not recommend carotid endarterectomy for people who have
narrowing of the carotid arteries in the neck but have no symptoms,
unless the patient's risk of complication is less than 3 percent.
Carotid endarterectomy is a type of surgery meant to reduce the
risk of stroke.
The recommendations were published online recently in the
Here's where you can learn more about the
NewsCopyright © 2013
All rights reserved.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © EBSCO Publishing. All rights reserved.