Medically Unexplained Symptoms - Robert W. Baloh

Medically Unexplained Symptoms

A Brain-Centered Approach

Despite the rapid advances in medical science, the majority of people who visit a doctor have medically unexplained symptoms (MUS), symptoms that remain a mystery despite extensive diagnostic studies. The most common MUS are back pain, abdominal pain, headache, fatigue, and dizziness. Les mer
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Paperback
Legg i
Vår pris: 156,-

(Paperback)
Leveringstid: Sendes innen 7 virkedager

Despite the rapid advances in medical science, the majority of people who visit a doctor have medically unexplained symptoms (MUS), symptoms that remain a mystery despite extensive diagnostic studies. The most common MUS are back pain, abdominal pain, headache, fatigue, and dizziness. This book addresses the obstacles of managing people with MUS in our modern day society from both a historical and contemporary perspective.

Most MUS are psychosomatic in origin, caused by a complex interaction between nature and nurture, between biological and psychosocial factors. Psychosomatic symptoms are as real and as severe as the symptoms associated with structural damage to the brain. Unique and concise, the book explores the biological and psychosocial mechanisms, the clinical features, and current and future treatments of common MUS.

Exploring the unsolved in an accessible manner, Medically Unexplained Symptoms invokes the methodologies of medical science, history, and sociology to investigate how brain flaws can lead to debilitating symptoms.
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Utgitt:
Forlag: Springer Nature Switzerland AG
Innbinding: Paperback
Språk: Engelsk
Sider: 204
ISBN: 9783030591809
Format: 24 x 16 cm
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Introduction







Chapter 1. Overview of Medically Unexplained Symptoms



Pain



Brain flaws



Fear



Anxiety



Dizziness



Stress



Fatigue



Diagnostic uncertainty







Chapter 2. Early ideas on hysteria



Hysteria and female sexuality



Bizarre behaviors



Hysteria and the occult



Nerves



Hysteria, a nervous disorder



Early treatments of hysteria



Spinal irritation and the spinal reflex theory



The attack on the female genitalia



Hysteria and fasting girls







Chapter 3. The Golden age of Hysteria



Briquet's syndrome



Charcot and his hysterical circus



Hysteria and hypnosis



Borderlands of hypnosis



Nature or nurture



Ideas about hysteria evolve



Neurasthenia and neurosis



Americanitis



S Weir Mitchell and the Civil War



The Rest Cure



S Weir Mitchell, the enigma



Nerve doctors



Evolution and the brain







Chapter 4. Psychosomatic illness in the 20th Century



Freud, the early years



Breuer's famous patient, Bertha Pappenheim



Freud and Breuer's book on hysteria



Suppressed memories and childhood sexuality



Freud's model of the mind



Overall impact of psychoanalysis



Physicians, patients and psychosomatic symptoms



Common sense psychotherapy



Alternate medical treatments and suggestibility



War and Psychogenic Illness



PTSD the prototypical delayed stress disorder



Relationship between PTSD and mild traumatic brain injury (mTBI)



Psychosomatic medicine







Chapter 5. Biological mechanisms of Psychosomatic Symptoms



The biological link between stress and illness



The hypothalamic-sympathetic-adrenal axis



The brain's emotional center, the limbic system



The hypothalamic-pituitary-adrenal axis



Pavlov and neural plasticity



Hebb's Synapse



Molecular mechanisms of brain plasticity



Stress and the limbic system



Nerve growth factors and stress



The amygdala-prefrontal cortex connection



Central sensitization, a model of neuroplasticity



The descending pain modulatory system (DPMS)



Brain neurotransmitters



Gamma aminobutyric acid (GABA)



Noradrenalin



Serotonin



Dopamine



Cannibinoids



Stress and human behavior



Operant conditioning and behavioral therapy







Chapter 6. Psychosocial mechanisms of psychosomatic Symptoms



How can beliefs and expectations change brain function?



Doctor patient relationship and psychosomatic symptoms



The power of the placebo



Placebo's evil twin, nocebo



Statins and muscle pain and weakness



Glutens and Celiac disease



Expectations and beliefs



Hyperventilation syndrome



Idiopathic environmental intolerance and the nocebo effect



The Belgium Coca-Cola fiasco



Electromagnetic hypersensitivity



Infrasound sensitivity



Sick building syndrome



Summary of Idiopathic environmental intolerance mechanisms







Chapter 7. Low back pain, abdominal pain and headache



Overview of common pain syndromes



Low back pain



Historical perspective



Current approach to chronic low back pain



Physical activity and expectation



Depression and fear avoidance



Abdominal pain



Autonomic nervous system and the gut



Irritable bowel syndrome (IBS)



Peptic ulcer disease



Primary headache disorders



Migraine as a model for psychophysiological illnesses



Historical perspective



Migraine Auras



Early ideas on the cause of migraine



Mechanism of the migraine aura



Genetic susceptibility to migraine







Chapter 8. Fibromyalgia/Chronic Fatigue Syndrome



Pain but much more



Fibromyalgia



Tender points



Central sensitization to pain



Repetitive strain injury (RSI)



Chronic fatigue



Epidemic and sporadic neuromyasthenia



Epstein-Barr virus (EBV)



Chronic fatigue immune dysfunction syndrome (CFIDS)



Myalgic encephalomyelitis (ME)



Overlap with depression and other psychogenic illnesses



Genetics of fibromyalgia and chronic fatigue syndrome







Chapter 9. Chronic dizziness



Anxiety and Dizziness



Near faint dizziness and fainting



Postural orthostatic tachycardia syndrome (POTS)



Dizziness and mass psychogenic illness



Persistent Postural Perceptual Dizziness (PPPD)



Migrainous dizziness



Post Concussion Dizziness



Sea legs and mal de Debarquement syndrome



Height vertigo and acrophobia







Chapter 10. Treatment of psychosomatic symptoms



Lifestyle changes



Exercise and the brain



Sleep and eating habits



Mindfulness



Cognitive Behavioral Therapy



Internet Directed Therapy



Drug treatments



Drugs that increase brain monoamines (antidepressants)



Drugs that decrease excitatory (glutamate) transmission



Antiepileptic drugs



Anxiolytic drugs



Drugs that enhance neuroplasticity and neurogenesis



Ketamine, the new "wonder drug"



Drugs that effect endocannibinoid neurotransmission



Extracranial Brain stimulation



Electroconvulsive therapy (ECT)



Transcranial direct current stimulation (tDCS)



Transcranial magnetic stimulation (TMS)



Deep brain stimulation



DBS for PTSD



Future Directions
Robert W. Baloh MD



Distinguished Professor of Neurology



David Geffen School of Medicine at UCLA



Los Angeles, CA