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Update on Treatment of Idiopathic (and Non-Idiopathic) Orbital Inflammation Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2024-03-26 Elana Meer, Michael K. Yoon, Jonathan E. Lu
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Management Strategies for Atypical Parkinsonism Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2024-03-21 Vasilios C. Constantinides, Nikolaos Giagkou, Maria-Evgenia Brinia, Christos Koros, Leonidas Stefanis, Maria Stamelou
Purpose of Review Atypical parkinsonism is a term usually used to describe three neurodegenerative parkinsonian disorders: progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), and multiple system atrophy (MSA). In contrast to Parkinson’s disease, these disorders have a poor prognosis and present with a multitude of diverse symptoms, including parkinsonism, dystonia, myoclonus, gait
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Distinguishing Benign Rashes From Severe Skin Reactions From Anti-Seizure Medications Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2024-03-21 Ram Mani, Ahmad Almelegy, Thu Minh Truong, Gaurav N. Pathak, Mary L. Wagner, Cindy Wassef
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Treatment Approaches in Pediatric Relapsing Autoimmune Encephalitis Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2024-03-21
Abstract Purpose of review Autoimmune encephalitis (AE) is increasingly recognized as a treatable cause of encephalitis in children. While prior observational studies demonstrate improved motor outcomes with early immunotherapy, less is known about long-term management and treatment for relapsing disease. In this review, we present current treatment approaches to pediatric AE, in particular relapse
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Ethical Considerations in the Treatment of Cerebrovascular Disease Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2024-03-15 Nathan A. Shlobin
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Early Mobilization in Neurocritical Care Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2024-02-06 Kristen Nobles, Kiersten Norby, Kristina Small, Monisha A. Kumar
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Update on Amyloid Polyneuropathy and Treatment Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2024-02-01
Abstract Purpose of Review The purpose of this review is to summarize currently available and developing diagnostic and treatment options for hereditary transthyretin amyloid polyneuropathy. Transthyretin amyloidosis (ATTR) predominantly manifests with cardiomyopathy and/or peripheral neuropathy, but amyloid deposits may be found in other organs or tissues. Recent Findings Currently available treatments
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Translating the ALS Genetic Revolution into Therapies: A Review Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2024-01-30 Christine Meadows, Naraharisetty Anita Rau, Warda Faridi, Cindy V. Ly
Purpose of Review Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease causing weakness, respiratory failure, and death within 3 to 5 years. Approximately, 10% of ALS cases have a genetic etiology (familial/fALS). The etiology of the remaining 90% of sporadic ALS (sALS) cases remains unknown. In this review, we provide an overview of approved and investigational therapies for fALS, as
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A New Era in the Treatment of Myasthenia Gravis: Six New Medications in The Last 6 Years Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2024-01-23 Ashish D. Patel, Aashin Shah, J. David Avila
Purpose of Review This article presents a summary of the new medications approved for generalized myasthenia gravis (gMG) since 2017. Pivotal clinical trials that led to the approval of these medications and their open-label extension studies are reviewed. We also provide information on healthcare cost when available. Lastly, we propose an approach to selecting therapies. Recent Findings Six new medications
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Progressive Supranuclear Palsy Diagnosis and Treatment Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2024-01-18 Lauryn Currens, Alexander Pantelyat
Purpose of review This review describes the current approaches to the diagnosis and management of progressive supranuclear palsy (PSP) Recent findings PSP is an atypical parkinsonian disorder associated with the accumulation of abnormal 4-repeat tau protein in the brain. Initially, the recognized clinical phenotype included a progressive disorder with vertical supranuclear gaze palsy and prominent
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Vasculitic Neuropathies Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2024-01-11 Avi Landman, Mark Levine, Andrés M. De León
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The Role of Rehabilitation in Neurological Critical Care: Innovations in Early Mobilization Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-12-07 Alicia O’Hara, Marie Newkirk, Mina Girgis, Carrie Esopenko, David Putrino, Laura Tabacof, Christopher Kellner, Jenna M. Tosto-Mancuso
Purpose of review This review appraises the existing literature to highlight the benefits, barriers, and role of rehabilitation in the early mobilization of patients in neurological critical care. Recent findings While the benefits of early mobilization in patients with critical illness have become more widely acknowledged, there are benefits and challenges to the successful implementation of early
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An Update on Palliative Care in Neurocritical Care: Providing Goal-Concordant Care in the Face of Prognostic Uncertainty Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-12-05 Kristopher A. Hendershot, Maya N. Elias, Breana L. Taylor, Sarah Wahlster, Claire J. Creutzfeldt
Purpose of review We investigate the complexities and interplay between the concepts of prognostic uncertainty and patient preferences as they relate to the delivery of goal-concordant care to patients with severe acute brain injuries (SABI) in the Neurological Intensive Care Unit (Neuro-ICU). Recent findings Patients with SABI in the Neuro-ICU have unique palliative care needs due to sudden, often
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Emerging Principles for Treating Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-11-22 Andrew B. Wolf, Jacqueline Palace, Jeffrey L. Bennett
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Epilepsy Treatment in Patients with Heart Disease Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-11-06 Scott Mintzer
Purpose of review This review highlights issues pertaining to the treatment of seizures in patients with cardiac disease. These fall into two categories: impacts upon the native disease — primarily an issue with coronary artery disease and arrhythmia — and drug interactions, which are important in all types of cardiac disease. Recent findings A sizeable body of evidence indicates that enzyme-inducing
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Speech Language Pathology in the Neurocritical Care Unit Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-10-09 Nicole Frost, Gavin Yuan, Julie Zhang, Amy Rickard, Erin McGee, Michelle DiMattia, Stephan A. Mayer
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Epilepsy Management in Transgender and Gender Diverse People Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-10-07 Catherine V. Kulick-Soper, Genna Waldman
Purpose of review The goal of this review is to outline important topics in epilepsy management for transgender and gender diverse individuals. Specifically, we describe the common gender-affirming hormone treatment regimens, how these changes in estrogens and androgens may affect seizure threshold and anti-seizure medications, and how anti-seizure medications may in turn impact hormone levels. Recent
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The Role of Pharmacy in Neurocritical Care Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-10-05 Jeffrey J. Mucksavage, Eljim P. Tesoro
Purpose of review This review presents the evolution of clinical pharmacy services in critical care and describes the roles of pharmacists specifically in the setting of the neurocritical care unit and the field of neurocritical care in general. Recent findings Several studies show that clinical pharmacists in critical care are associated with reductions in mortality, ICU stay, medical costs, and adverse
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The A2F ICU Liberation Bundle in Neurocritical Care Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-10-02 Michael E. Reznik, Alexis Steinberg, Lori A. Shutter, Timothy D. Girard
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The Need for Continuity of Care in Neurocritical Care and Recovery Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-10-03 Jeremy Ader, Sachin Agarwal, Imama A. Naqvi
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Seizures in the Setting of COVID-19 Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-10-03 Brigitte Reina, Michael L. Fitzpatrick, George W. Culler, Barbara C. Jobst
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Shared Decision-Making and Family Meetings in Neurocritical Care Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-09-12 Shazeb Meraj, Shravan Sivakumar, Susanne Muehlschlegel
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Clinical Practice Update Part II: Considerations for Treatment and Management of Benign Paroxysmal Positional Vertigo Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-09-06 Allison L. Nogi, Andrew Fischer, Daniel Ludwig, Jennifer Millar
Purpose of review Although benign paroxysmal positional vertigo (BPPV) can be diagnosed and treated at bedside with positional testing and maneuvers, clinicians need to be aware of complications of maneuvers and factors that influence the treatment and education of BPPV. Appropriate integration of supplemental factors when managing BPPV will empower the clinician and may optimize treatment. Recent
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Recommendations for Family Presence at the Bedside in Neurocritical Care Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-09-08 Natalie Kreitzer, Nathan Rodrigues, Tamilyn Bakas
Purpose of review The purpose of this review is to summarize the latest evidence regarding family presence at the bedside in the neuro-ICU. Benefits, drawbacks, and recommendations are provided to support family members of persons receiving neurocritical care. Recent findings Family presence at the bedside can support positive outcomes for patients, family members, and health care staff. Recent findings
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Clinical Practice Update Part I: Diagnosis and Treatment for Benign Paroxysmal Positional Vertigo Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-09-04 Allison L. Nogi, Daniel Ludwig, Jennifer Millar
Purpose of review Benign paroxysmal positional vertigo (BPPV) can be diagnosed and treated at bedside with positional testing and maneuvers. Appropriate and timely recognition and treatment for BPPV can ameliorate symptoms of vertigo and spinning, reduce fall risk and healthcare costs, and minimize disability. Although medications may transiently reduce symptoms, they do not address the underlying
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Treatment of Persistent Postural-Perceptual Dizziness (PPPD) Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-08-21 Aaron Trinidade, Verónica Cabreira, Diego Kaski, Joel Goebel, Jeffrey Staab, Stoyan Popkirov, Jon Stone
Purpose of Review When persistent postural-perceptual dizziness (PPPD) entered the diagnostic nomenclature in 2017, treatment options were adopted from its predecessors, including use of vestibular rehabilitation, psychotherapy, and serotonin reuptake inhibitors. Individualised treatment may require additional interventions to cover the full range of precipitating and perpetuating factors and medical
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Biomarker Defined Acute Optic Neuritis: A Review and Perspective Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-08-15 Mišo Gostimir, Robert C. Sergott
Purpose of review This review provides a comprehensive summary of treatment options and management considerations for patients with acute inflammatory optic neuritis. A critical appraisal of the findings from landmark trials to the more recent studies is presented to provide a reference for diagnostic approaches, treatment options, and future research perspectives. Recent findings The Optic Neuritis
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Update on Therapy for Myotonic Dystrophy Type 1 Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-07-14 Vukan Ivanovic, Giovani Meola, Zoran Vukojevic, Stojan Peric
Purpose of review This review aimed to summarize the clinical characteristics of myotonic dystrophy type 1 and to provide a comprehensive review of the current management options for DM1 patients. Recent findings Tremendous advances in understanding the molecular pathophysiology of the disease have led to the first successful preclinical or even clinical studies of disease-modifying therapies. Repurposed
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Update on Large-Vessel Revascularization in Acute Ischemic Stroke Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-07-01 Vasu Saini, Vera Sharashidze, Isaac Josh Abecassis, Luis Guada, Jude Hassan Charles, Kaustubh Limaye, Dileep R. Yavagal
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Update on Transient Global Amnesia (TGA): Current Theories Underlying the Etiology, Diagnosis, Prognosis, and Management of TGA Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-07-03 Nara Miriam Michaelson, Sarah A. Friedman, Judy H. Ch’ang
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Update on ALS Treatment Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-06-20 Shubadra Priyadarshini, Senda Ajroud-Driss
Purpose of Review While amyotrophic lateral sclerosis (ALS) remains a progressive fatal diagnosis, there have been numerous advances in the last several years, both in disease-modifying and symptomatic treatment. This review aims to provide a comprehensive and updated review of the literature of current treatment options for ALS. Recent Findings We will discuss the proposed mechanisms of action, evidence
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Article Topic: Neuropathies Due to Infections and Antimicrobial Treatments Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-06-10 Andrés M. De León, Rocio Garcia-Santibanez, Taylor B. Harrison
Purpose of eview The aim of this review is to discuss the presentation, diagnosis, and management of polyneuropathy (PN) in selected infections. Overall, most infection related PNs are an indirect consequence of immune activation rather than a direct result of peripheral nerve infection, Schwann cell infection, or toxin production, though note this review will describe infections that cause PN through
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Diagnosis and Treatment of Inflammatory Cerebral Amyloid Angiopathy Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-05-18 Samuel S. Bruce, Neal S. Parikh
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Ocular Myasthenia Gravis Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-04-19 Alexander H. Morrison, Grant T. Liu, Ali G. Hamedani
Purpose of review To review the diagnosis and current treatments for ocular myasthenia gravis (OMG) with a focus on recent advances. Recent findings Novel microRNA biomarkers show promise in predicting which patients with OMG will subsequently develop generalized disease. Newly developed clinical rating scales may enable more effective OMG-specific research. A recent meta-analysis suggested that treatment
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Cerebral Venous Thrombosis: Medical Management vs. Endovascular Therapy Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-04-11 Sabrina L. Begley, Timothy G. White, Jeffrey M. Katz
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Treatment Updates for Neuropathy in Hereditary Transthyretin Amyloidosis Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-04-10 Deandre King, K. H. Vincent Lau, Michelle C. Kaku
Purpose of review To present an overview of current and upcoming therapies for hereditary transthyretin-mediated amyloidosis with peripheral neuropathy. Recent findings. Hereditary transthyretin-mediated amyloidosis (hATTR) also known as ATTRv (v for variant) is a rare, progressively debilitating disease associated with high morbidity. The past decades have seen the development of TTR stabilizers including
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Clinical Management in Alzheimer’s Disease in the Era of Disease-Modifying Therapies Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-03-21 Michael H. Guo, Sanjeev N. Vaishnavi
Purpose of review Discuss emerging anti-amyloid disease-modifying therapies for Alzheimer’s disease (AD) and outline how these therapies will change our clinical management of patients with AD. Recent findings Building on decades of preclinical work supporting an initiating role of amyloid-β (Aβ) in driving downstream neurodegeneration in AD, monoclonal antibody therapies have been developed against
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Parkinson Disease Dementia Management: an Update of Current Evidence and Future Directions Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-03-13 Oliver Phillips, Debolina Ghosh, Hubert H. Fernandez
Purpose of Review Parkinson disease dementia (PDD) is a multisystem disorder involving motor and nonmotor symptoms. Therapeutic options for management of cognitive and neuropsychiatric symptoms are relatively limited when compared to motor symptoms and have been an active area of study. We present the reader with a critical appraisal of evidence for approved and recently investigated therapies in the
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Cerebrovascular Manifestations of SARS-CoV-2: A Comprehensive Review Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-03-04 Εleni Stefanou, Nikolaos Karvelas, Samuel Bennett, Christo Kole
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Rescue Medications for Acute Repetitive Seizures Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-03-04 Jonathan Dashkoff, Barbara A. Dworetzky, Ellen J. Bubrick
Purpose of review This article reviews the current evidence-based treatments for the management of acute repetitive seizures (ARS). Recent findings Half of patients with refractory epilepsy will experience ARS, but rescue medications are underutilized. Benzodiazepines remain first-line treatment for the management of acute seizures. There are multiple approved medications, and ongoing studies investigating
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An Update on the Treatment of Basilar Artery Occlusion Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-03-03 Jacob S. Kazmi, Boris Chulpayev, Richard S. Jung, Jeffrey M. Katz
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Diagnosis and Management of Posterior Cortical Atrophy Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2023-02-08 Keir X. X. Yong, Jonathan Graff-Radford, Samrah Ahmed, Marianne Chapleau, Rik Ossenkoppele, Deepti Putcha, Gil D. Rabinovici, Aida Suarez-Gonzalez, Jonathan M. Schott, Sebastian Crutch, Emma Harding
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Diagnosis and Treatment of Poststroke Epilepsy: Where Do We Stand? Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-12-01 Matthias Mauritz, Kai-Nicolas Poppert, Eugen Trinka, Sebastian Mutzenbach
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Self-care and Epilepsy Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-10-08 Stephen E. Rostad, Gena R. Ghearing
Purpose of Review Despite advancements in medical and surgical therapies, many people with epilepsy continue to have seizures or have other comorbidities impacting their wellbeing. Self-management interventions have been shown to benefit people with other chronic diseases, and this review will examine the increasing evidence for a role of self-care as part of comprehensive, patient-centered epilepsy
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Fenfluramine for the Treatment of Dravet Syndrome and Lennox Gastaut Syndrome: A Review Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-09-24 Douglas R. Nordli, Fernando N. Galan
Purpose of Review Treatment-resistant epilepsy comprises approximately 36.3% of neurology clinic-based populations in the USA. Despite new drug development over the past 50 years, the rates of drug-resistant epilepsy remain the same. The need for continued drug trials with novel mechanisms of action remains paramount in patients with drug-resistant epilepsy. In particular, patients with severe epilepsy
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Treatment of Epilepsy in the Setting of Cognitive Decline in Older Adults Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-09-19 Jamie Mayo, Samin Panahi, Ali Roghani, Anne C. Van Cott, Mary Jo Pugh
Purpose of Review Discuss the state of the literature for the treatment of comorbid epilepsy and cognitive dysfunction, specifically focusing on the older adult. Recent Findings Epilepsy and cognitive dysfunction are neuronal network disorders with converging molecular underpinnings. Anti-seizure medication is not obligatory after the first instance of a seizure in the setting of cognitive dysfunction
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Treatment of Intracerebral Vascular Malformations: When to Intervene Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-09-15 Rawad Abbas, Fadi Al-Saiegh, Elias Atallah, Kareem El Naamani, Stavropoula Tjoumakaris, Michael R. Gooch, Nabeel A. Herial, Pascal Jabbour, Robert H. Rosenwasser
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Mass Spectrometry-Based Approaches for Clinical Biomarker Discovery in Traumatic Brain Injury Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-09-15 Matthew Creech, Lindsey Carvalho, Heather McCoy, Jon Jacobs, H. E. Hinson
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Temperature Control in Hypoxic-Ischemic Brain Injury—a Focused Update Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-09-05 Nicholas J. Nelson, Briana E. Wasserstrom, Carolina B. Maciel
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Predicting and Treating Post-traumatic Epilepsy Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-09-01 Clio Rubinos, Brandon Waters, Lawrence J. Hirsch
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Management of External Ventricular Drains and Related Complications: a Narrative Review Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-08-31 Haamid H. Siddique, Hussam Elkambergy, Ahmad Bayrlee, Yasser B. Abulhasan, Florian Roser, Jamil R. Dibu
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Update on Therapies for Mal de Débarquement Syndrome Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-08-19 Yoon-Hee Cha
Purpose of Review This review will discuss current treatment options for mal de débarquement syndrome (MdDS) and non-motion triggered persistent oscillating vertigo (nmPOV). Therapies available in most clinical settings such as modifying homeostatic factors (sleep, stress, menstrual cycle, visual stimulation), medications (benzodiazepines, serotonin reuptake inhibitors), and vestibular/physical therapy
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Telestroke’s Role Through the COVID-19 Pandemic and Beyond Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-08-19 Ehab Harahsheh, Stephen W. English, Courtney M. Hrdlicka, Bart Demaerschalk
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Treatment of Fever in Neurologically Critically Ill Patients Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-08-16 Jamil R. Dibu, Rehan Haque, Samer Shoshan, Yasser B. Abulhasan
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Brain-Lung Crosstalk: Management of Concomitant Severe Acute Brain Injury and Acute Respiratory Distress Syndrome Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-08-10 Nassim Matin, Kasra Sarhadi, C. Patrick Crooks, Abhijit V. Lele, Vasisht Srinivasan, Nicholas J. Johnson, Chiara Robba, James A. Town, Sarah Wahlster
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Quality Improvement in Neurocritical Care: a Review of the Current Landscape and Best Practices Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-08-06 Navaz Karanjia, Venkataditya Dugyala, Casey Olm-Shipman, Abhijit V. Lele
Purpose of Review The field of neurocritical care (NCC) has grown such that there is now a substantial body of literature on quality improvement specific to NCC. This review will discuss the development of this literature over time and highlight current best practices with practical tips for providers. Recent Findings There is tremendous variability in patient care models for NCC patients, despite
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A Review of the Current Literature and Updates on Embolic Stroke of Undetermined Source (ESUS) Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-08-06 Bhanu Gogia, Saad Hasan, Marc Fisher
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Pompe Disease: a Clinical, Diagnostic, and Therapeutic Overview Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-08-04 David Stevens, Shadi Milani-Nejad, Tahseen Mozaffar
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Tenecteplase or Alteplase: What Is the Thrombolytic Agent of the Future? Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-07-30 Ammad Mahmood, Keith W. Muir
Purpose of review Alteplase has been the thrombolytic of choice for acute ischaemic stroke for more than two decades. A thrombolytic which is easier to administer and with improved or comparable safety and efficacy is desirable. Tenecteplase has emerged as a potential successor, and its off-license use in acute ischaemic stroke has increased in recent years. We aimed to examine the evidence base for
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Optimizing Sleep and Circadian Health in the NeuroICU Curr. Treat. Options Neurol. (IF 2.0) Pub Date : 2022-07-15 Jamie Nicole LaBuzetta, Atul Malhotra, Phyllis C. Zee, Matthew B. Maas
Purpose of Review This article introduces fundamental concepts in circadian biology and the neuroscience of sleep, reviews recent studies characterizing circadian rhythm and sleep disruption among critically ill patients and potentially links to functional outcomes, and draws upon existing literature to propose therapeutic strategies to mitigate those harms. Particular attention is given to patients