All clinicians, regardless of their specialty, encounter patients with weakness, altered sensation, headaches, "spells" dizziness, sleepiness, mental status changes, and other symptoms that reflect dysfunction of one or more parts of the nervous system. Clinicians need to know how to evaluate such patients, how to determine if the patients are likely to have a neurologic condition, and how to manage them, at least in the initial stages. This book, written by the lead author of the widely cited Neurology Clerkship Core Curriculum, covers the material that clinicians need to know in order to assess and manage the patients they will encounter in general medical practice. The focus throughout is on the "how" and "why" of clinical neurology. Naturally, the book includes extensive factual material about individual disease processes, but the emphasis is on information that is important for understanding why patients with neurologic conditions are managed the way they are. The first three chapters of the book present a systematic way to think about patients with neurologic symptoms, applying a logical approach to diagnosis rather than relying on pattern recognition. Because the neurologic examination is fundamental to diagnosis, this book provides a detailed description of how to perform each step of the examination and an even more extensive discussion of how to interpret the findings. The remaining chapters cover the management of specific disease categories and symptoms, always stressing the reasons for doing particular tests and the rationale for the various treatment options. Although the book does not cite the original literature, it reflects the most current evidence available at the time of publication.
Author(s): Douglas Gelb MD PhD
Edition: 4
Publisher: Oxford University Press, USA
Year: 2010
Language: English
Pages: 528
Tags: Медицинские дисциплины;Неврология и нейрохирургия;
Cover......Page 1
Contents......Page 14
Contributors......Page 24
PART 1: The Basic Approach......Page 28
I. Sample Localization Problems......Page 30
II. The Game......Page 31
III. The Rules......Page 33
IV. The Play: The Long Version......Page 34
V. The Play: The Abbreviated Version......Page 41
VI. Rules for Speed Play......Page 63
II. General Comments on the Neurologic Examination......Page 68
III. How to Do the Neurologic Examination......Page 73
IV. Additional Comments on Terminology and Examination Technique......Page 85
V. Interpretation of the Neurologic Examination......Page 95
VI. Modifications of the Neurologic Examination......Page 112
VII. Discussion of Localization Problems......Page 118
I. Case Histories......Page 119
II. Beyond Localization......Page 121
III. Etiology......Page 124
IV. Discussion of Case Histories......Page 128
PART II: Common Diseases......Page 134
I. Case Histories......Page 136
II. Approach to Stroke......Page 137
III. Background Information......Page 138
IV. Diagnosis......Page 140
V. Management of Acute Stroke......Page 147
VI. Primary Prevention......Page 152
VII. Secondary Prevention of Ischemic Stroke......Page 156
IX. Discussion of Case Histories......Page 167
I. Case Histories......Page 172
II. Approach to Seizures......Page 173
III. Background Information......Page 174
IV. Diagnosis......Page 181
V. Determining the Cause of Seizures......Page 185
VI. Management of Seizures and Epilepsy......Page 188
VII. Special Clinical Problems......Page 203
VIII. Discussion of Case Histories......Page 207
I. Case Histories......Page 210
II. Approach to Neuromuscular Diseases......Page 212
III. Background Information......Page 213
IV. Specific Neuromuscular Diseases......Page 216
V. Symptomatic Treatment......Page 233
VI. Discussion of Case Histories......Page 234
I. Case Histories......Page 237
II. Approach to Dementing Illnesses......Page 239
III. Primary Dementing Illnesses......Page 245
IV. Discussion of Case Histories......Page 264
I. Case Histories......Page 267
III. Background Information......Page 268
IV. Specific Movement Disorders......Page 271
V. Discussion of Case Histories......Page 293
I. Case Histories......Page 295
II. Approach to Sleep Disorders......Page 296
III. Background Information......Page 297
IV. Trouble Staying Awake......Page 301
V. Trouble Sleeping......Page 305
VI. Abnormal Behavior During Sleep......Page 309
VII. Discussion of Case Histories......Page 313
I. Case Histories......Page 316
III. Focal Diseases with Multifocal Propagation......Page 318
IV. Inherently Multifocal Diseases......Page 336
V. Discussion of Case Histories......Page 350
PART III: Common Symptoms......Page 354
I. Case Histories......Page 356
II. Background Information......Page 357
III. Approach to Acute Changes in Level of Consciousness......Page 359
IV. Special Circumstances......Page 367
V. Discussion of Case Histories......Page 372
I. Case Histories......Page 374
III. Background Information......Page 375
IV. Headache Emergencies: Subarachnoid Hemorrhage and Bacterial Meningitis......Page 377
V. Other Secondary Headaches......Page 379
VI. Primary Headaches......Page 386
VII. Discussion of Case Histories......Page 399
I. Case Histories......Page 401
III. Approach to Visual Symptoms......Page 402
IV. Monocular Vision Loss......Page 403
V. Transient Vision Loss (Monocular or Binocular)......Page 405
VII. Diplopia......Page 406
VIII. Discussion of Case Histories......Page 409
I. Case Histories......Page 411
IV. Vertigo......Page 413
V. Disequilibrium......Page 421
VI. Discussion of Case Histories......Page 422
I. Case Histories......Page 424
II. Approach to Back or Neck Pain......Page 425
III. Specific Conditions Causing Back or Neck Pain......Page 426
IV. Discussion of Case Histories......Page 429
I. Case Histories......Page 431
III. Approach to Incontinence......Page 432
IV. Discussion of Case Histories......Page 435
PART IV: Bookends......Page 438
I. Case Histories......Page 440
II. Developmental Considerations......Page 442
III. Hypotonic Infants......Page 443
IV. Developmental Delay and Developmental Regression......Page 444
V. Paroxysmal Symptoms......Page 447
VI. Gait Disturbance......Page 449
VII. Discussion of Case Histories......Page 450
I. Case Histories......Page 456
III. The Neurologic Examination in Normal Aging......Page 458
IV. Common Neurologic Symptoms in the Elderly......Page 461
V. Discussion of Case Histories......Page 463
I. Case Histories......Page 466
II. Answers......Page 469
A......Page 476
B......Page 480
C......Page 482
D......Page 488
E......Page 491
F......Page 493
G......Page 495
H......Page 496
I......Page 499
L......Page 501
M......Page 504
N......Page 508
O......Page 510
P......Page 511
R......Page 516
S......Page 518
T......Page 523
V......Page 526
Z......Page 528
