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Neurology Group Lists Procedures That May Be Unneeded
Date:3/8/2013

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 release.

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 lists.

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
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