Front Matter
Copyright
FOREWORD
PREFACE
SECTION I
General approach to history and examination-1-32
Nervous system - history-2
Nervous system - examination-4
Examination - conscious level assessment-5
Examination - higher cerebral function-7
Cranial nerve examination-9
Examination - upper limbs-18
Examination - trunk-24
Examination - lower limbs-24
Examination - posture and gait-28
Examination of the unconscious patient-29
The neurological observation chart-31
SECTION II
Investigations of the central and peripheral nervous systems-33
Skull X-ray-34
Computerized tomography (CT) scanning-35
Magnetic resonance imaging (MRI)-39
Ultrasound-44
Angiography-45
Radionuclide imaging-48
Electroencephalography (EEG)-51
Intracranial pressure monitoring-52
Evoked potentials - visual, auditory and somatosensory-54
Evoked potentials - somatosensory-55
Lumber puncture (LP)-56
Cerebrospinal fluid-57
Electromyography/nerve conduction studies-58
Neuro-otological tests-62
SECTION II
Clinical presentation, anatomical concepts and diagnostic approach-67
Headache - general principles-68
Headache - diagnostic approach-69
Headache-special causes-70-74
Meningism-75
Raised intracranial pressure-76
Coma and impaired conscious level-85
Transient loss of consciousness-90
Confusional states and delirium-91
Epilepsy-92
Seizure classification-93
The partial seizures-94
Partial seizures evolving to tonic/clonic convulsion-96
Generalized seizures-97
Symptomatic seizures-98
Seizures - differential diagnosis-99
Epilepsy-classification-100
Epilepsy-investigation-101
Epilepsy-treatment-102
Epilepsy-surgical treatment-103
Epilepsy-specific issues-104
Status epilepticus-105
Disorders of sleep-106
Higher cortical dysfunction-109
Frontal lobes-111
Parietal lobes-112
Temporal lobes-114
Occipital lobe-115
Apraxia-116
Higher cortical dysfunction-disconnection syndromes-117
Higher cortical function-memory-118
Disorders of memory-119
Disorders of speech and language-120
Disorders of speech-dysarthria-121
Disorders of speech – dysphonia-122
Disorders of speech – dysphasia-123
Dementias-125
Dementias – classification-126
Dementias – history and clinical examination-127
Dementias – specific diseases-128
Dementia – diagnostic approach-132
Impairment of vision-133
Disorders of smell-141
Pupillary disorders-142
Diplopia – impaired ocular movement 147–154
Disorders of gaze-155
Facial pain and sensory loss-158
Facial pain – diagnostic approach-162
Facial pain – trigeminal neuralgia-163
Facial pain – other causes-165
Facial weakness-166
Bell’s palsy-170
Other facial nerve disorders 171
Deafness, tinnitus and vertigo-172
Disorders of the lower cranial- nerves-175
Causes of lower cranial nerve palsies-179
Cerebellar dysfunction-180
Symptoms and signs of cerebellar dysfunction-182–183
Classification of cerebellar dysfunction-183
Nystagmus-184
Tremor-188
Myoclonus-190
Disorders of stance and gait-191
Specific disorders of stance and gait-192
Limb weakness-193
Sensory impairment-199
Pain-204
Pain – treatment-206
Pain syndromes-208
Limb pain 210
Muscle pain (myalgia) 212
Outcome after brain damage-214
Brain death-215
Disorders of speech – dysphonia 122
Disorders of speech – dysphasia 123–124
Dementias 125
Dementias – classification 126
Dementias – history and clinical examination 127
Dementias – specific diseases 128–131
Dementia – diagnostic approach 132
Impairment of vision 133–140
Disorders of smell 141
Pupillary disorders 142–146
Diplopia – impaired ocular
movement 147–154
Disorders of gaze 155–157
Facial pain and sensory loss 158–161
Facial pain – diagnostic approach 162
Facial pain – trigeminal
neuralgia 163–164
Facial pain – other causes 165
Facial weakness 166–169
Bell’s palsy 170
Other facial nerve disorders 171
Deafness, tinnitus and vertigo 172–174
Disorders of the lower cranial
nerves 175–178
Causes of lower cranial nerve
palsies 179
Cerebellar dysfunction 180–181
Symptoms and signs of
cerebellar dysfunction 182–183
Classification of cerebellar
dysfunction 183
Nystagmus 184–187
Tremor 188–189
Myoclonus 190
Disorders of stance and gait 191
Specific disorders of stance
and gait 192
Limb weakness 193–198
Sensory impairment 199–203
Pain 204–205
Pain – treatment 206–207
Pain syndromes 208–209
Limb pain 210–211
Muscle pain (myalgia) 212–213
Outcome after brain damage 214
Brain death 215–216
SECTION IV
Localised neurological disease and itsmanagement-217
A. Intracranial
Head injury 218–220
Head injury – clinical assessment-221
Head injury – investigation and referral criteria-226
Head injury – investigation-228
Head injury – management-230
Depressed skull fracture-234
Delayed effects of head injury-235
Chronic subdural haematoma-239
Cerebrovascular diseases-241
Cerebrovascular disease– mechanisms-242
Cerebrovascular disease– natural history-242
Cerebrovascular disease – causes-243
Occlusive and stenotic cerebrovascular disease-244
Cerebrovascular disease – pathophysiology- 245–246
Transient ischaemic attacks (TIAs)-247
Clinical syndromes – large vessel occlusion-248
Clinical syndromes – branch occlusion-254
Clinical syndromes – lacunar stroke (LACI)57
Classification of subtypes of cerebral infarction-258
Embolisation 258
Stenotic/occlusive disease – investigations 260
Cerebral infarction – management-262
TIAs and minor infarction– management-264
Hypertension and cerebrovascular disease 265
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CONTENTS
Chapter 3: CLINICAL PRESENTATION, ANATOMICAL CONCEPTS AND DIAGNOSTIC APPROACH
Chapter 4: LOCALISED NEUROLOGICAL DISEASE AND ITS MANAGEMENT A. INTRACRANIAL
Chapter 5: LOCALISED NEUROLOGICAL DISEASE AND ITS MANAGEMENT B. SPINAL CORD AND ROOTS
Chapter 6: LOCALISED NEUROLOGICAL DISEASE AND ITS MANAGEMENT C. PERIPHERAL NERVE AND MUSCLE
Chapter 7: MULTIFOCAL NEUROLOGICAL DISEASE AND ITS MANAGEMENT
FURTHER READING
INDEX