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Presented by the Johns Hopkins University School of Medicine.
Supported by educational grants and in-kind support from Allergan, Inc, Ipsen, Inc, Merz Pharmaceuticals, LLC, and Solstice Neurosciences, LLC, a WorldMeds company.

The Approach to Identifying Undiagnosed Patients: A Practical Guide
Joseph M. Savitt, MD, PhD
OVERVIEW

When managing patients with dystonia and spasticity, you aim to improve activities of daily living by improving mobility, reducing muscle tone, providing pain relief, and prevention of contractures. Unfortunately, the emphasis on training curricula for all practicing physicians, as well as physical medicine and rehabilitation (PM&R) residents and fellows, is variable and sometimes lacking structured training in the appropriate use and administration of chemodenervation agents.

This web lecture is part of a series of 4 activities discussing various aspects of diagnosis, treatment, and management for patients with dystonia and spasticity. In this talk, Dr Savitt provides a practical guide to identifying undiagnosed patients with dystonia or spasticity, including a discussion of presenting symptoms and methods for obtaining a precise history to improve your ability to diagnose patients with dystonia or spasticity.

GOAL

This web lecture is designed to provide neurologists and physiatrists with up-to-date information on hot to identify undiagnosed patients with dystonia or spasticity.

TARGET AUDIENCE

This activity is designed for residents and fellows in neurology and physical medicine and rehabilitation, community neurologists, physiatrists, and physical and occupational therapists. No prerequisites required.

LEARNING OBJECTIVES

After completing this activity, the participant will demonstrate the ability to:

  • Describe presenting signs and symptoms for patients who may have either dystonia or spasticity.
  • Evaluate questions and techniques that can be used to obtain a precise history and physical related to dystonia or spastic conditions.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

ACCREDITATION STATEMENT

The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT

The Johns Hopkins University School of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

After reviewing this online activity, participants may receive a certificate by completing the CME test, evaluation, and receiving a score of 75 % or higher. A certificate of participation will be available online immediately following successful completion of the activity.

The estimated time to complete this activity: 30 minutes.

Release date: December 1, 2012. Expiration date: December 1, 2014.

Full Disclosure Policy Affecting CME Activities
As a provider approved by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the Johns Hopkins University School of Medicine Office of Continuing Medical Education (OCME) to require signed disclosure of the existence of financial relationships with industry from any individual in a position to control the content of a CME activity sponsored by OCME. Members of the Planning Committee are required to disclose all relationships regardless of their relevance to the content of the activity. Faculty are required to disclose only those relationships that are relevant to their specific presentation. The following relationships have been reported for this activity:

Participating Faculty
Zoltan Mari, MD (Chair/Planner)

Director, National Parkinson Foundation Center of Excellence
Assistant Professor of Neurology
Johns Hopkins University School of Medicine

R. Samuel Mayer, MD (Planner)
Associate Professor
Vice Chair for Education
Department of Physical Medicine and Rehabilitation
Johns Hopkins University School of Medicine
Deputy Director, Quality Improvement
Department of Physical Medicine and Rehabilitation
The Johns Hopkins Hospital

Joseph M. Savitt, MD, PhD
Assistant Professor of Neurology
Johns Hopkins University School of Medicine
Parkinson's Disease and Movement Disorder Center of Maryland

Participating Faculty Disclosures
Dr Savitt reports serving on a discussion panel for Merz Pharmaceuticals, LLC.

Planner Disclosures
Dr Mari reports serving as the principal investigator for grants/research support from Allergan, Inc, Abbott Laboratories, Merz Pharmaceuticals, LLC, National Institutes of Health, National Parkinson Foundation, and The Michael J. Fox Foundation; and serving as a consultant for Ipsen, Inc and Medtronic.

Dr Mayer reports receiving grants from Allergan, Inc and Merz Pharmaceuticals, LLC.

No other planners have indicated that they have any financial interests or relationships with a commercial entity.

Note: Grants to investigators at The Johns Hopkins University are negotiated and administered by the institution that receives the grants, typically through the Office of Research Administration. Individual investigators who participate in the sponsored project(s) are not directly compensated by the sponsor, but may receive salary or other support from the institution to support their effort on the project(s).

Off-Label Product Discussion

The following faculty members have disclosed that their presentation will reference unlabeled/unapproved use of drugs or products:

Dr Savitt: OnabotulinumtoxinA (Botox® [Type A]), RimabotulinumtoxinB (Myobloc® [Type B]), AbobotulinumtoxinA (Dysport® [Type A]), and IncobotulinumtoxinA (Xeomin® [Type A])

DISCLAIMER

The opinions and recommendations expressed by faculty and other experts whose input is included in this activity are their own. This activity is produced for educational purposes only. Use of Johns Hopkins University School of Medicine name implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects before administering pharmacologic therapy to patients.

INTERNET CME POLICY

The Office of Continuing Medical Education (CME) at the Johns Hopkins University School of Medicine is committed to protect the privacy of its members and customers. Johns Hopkins University SOM CME maintains its Internet site as an information resource and service for physicians, other health professionals, and the public. Continuing Medical Education at the Johns Hopkins University School of Medicine will keep your personal and credit information confidential when you participate in a CME Internet based activity. Your information will never be given to anyone outside of the Johns Hopkins University School of Medicine’s CME activity. CME collects only the information necessary to provide you with the services that you request.

CONFIDENTIALITY DISCLAIMER FOR CME ACTIVITY PARTICIPANT

I certify that I am participating in this Johns Hopkins University School of Medicine activity for CME-accredited training and/or educational purposes.

I understand that while I am participating in this capacity, I may be exposed to "protected health information," as that term is defined and used in Johns Hopkins policies and in the federal HIPAA privacy regulations (the "Privacy Regulations"). Protected health information is information about a person’s health or treatment that identifies the person. I also understand that while I am participating in this capacity I will be treated as a temporary member of Johns Hopkins for purposes of the Privacy Regulations only.

I pledge and agree to use and disclose any of this protected health information only for the training and/or educational purposes of my visit and to keep the information confidential.

I understand that I may direct to the Johns Hopkins Privacy Officer any questions I have about my obligations under this Confidentiality Pledge or under any of the Hopkins policies and procedures and applicable laws and regulations related to confidentiality. The contact information is: Johns Hopkins Privacy Officer, telephone: 410-735-6509, e-mail: HIPAA@jhmi.edu.

“The Office of Continuing Medical Education at the Johns Hopkins University School of Medicine, as sponsor of this activity, has relayed information with the CME attendees/participants and certify that the visitor is here for training, education and/or observation purposes only.”

Johns Hopkins University School of Medicine
Office of Continuing Medical Education
720 Rutland Avenue/ Turner 20
Baltimore, Maryland 21205-2195
Reviewed & Approved by: General Counsel, Johns Hopkins Medicine (4/1/09)

HARDWARE AND SOFTWARE REQUIREMENTS

Pentium 800 processor or greater, Windows 98/NT/200/XP or Mac OS 9/X or later, Microsoft Internet Explorer, Safari, Firefox, Windows Media Player 9.0 or later Flash player, 128 MB of RAM Monitor settings: High color at 800 x 600 pixels, sound card and speakers, Adobe Acrobat Reader.

ACTIVITY CONTENTS

Please complete the pre-test, listen to the following presentation, and complete the post-test and evaluation to receive CME credit for this activity. A certificate of participation will be available online immediately following successful completion of the activity.

Pre-Test

The Approach to Identifying Undiagnosed Patients: A Practical Guide

Joseph M. Savitt, MD, PhD

Post-Test

procced to pretest




Johns Hopkins Advanced Studies in Medicine (ISSN-1558-0334), is published by Galen Publishing, LLC, d/b/a ASiM, PO Box 340, Somerville, NJ 08876. (908) 253-9001. Copyright ©2012 by Galen Publishing. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from the publisher. ASiM is a registered trademark of The Healthcare Media Group, LLC.