On Call Neurology

Front Cover
Inside Front Cover
On Call Neurology
Copyright
Dedication
Contributors
Preface
Contents
Structure of the Book
Phone call
Questions
Orders
Inform RN
Elevator thoughts
Major threat to life
Bedside
Quick Look Test
Vital Signs
Selective History and Chart Review
Selective Physical and Neurologic Examination
Management
Commonly Used Abbreviations
Introduction
Chapter 1: Approach to the Neurologic Patient On Call: History Taking, Differential Diagnosis, and Anatomic Localization
Principles of Managing Patients When On Call
Principles of History Taking in Neurology
Establishing the Initial Differential Diagnosis
Anatomic Localization
Chapter 2: The Neurologic Examination
The Neurologic Examination
Mental status
Cranial nerves
Motor
Coordination
Reflexes
Sensory
Gait and station
Chapter 3: Diagnostic Studies
Lumbar Puncture
Computed Tomography
Magnetic Resonance Imaging
Myelography
Doppler Ultrasonography
Angiography
Electromyography and Nerve Conduction Studies
Electroencephalography
Evoked Potentials
Muscle and Nerve Biopsy
Brain Biopsy
Patient-Related Problems: The Common Calls
Chapter 4: Acute Seizures and Status Epilepticus
Phone call
Questions
Orders
Inform RN
Elevator thoughts
Major threat to life
Bedside
Quick-Look Test
Management
Emergent Initial Therapy
Urgent Control Therapy
Treatment of Refractory Status Epilepticus
Treatment of Super Refractory Status Epilepticus
Ongoing Management
Chapter 5: Stupor and Coma
Phone call
Questions
Orders
Elevator thoughts
Major threat to life
Bedside
Selective History
Selective Physical Examination
General Physical Examination
Neurologic Examination
Diagnosis
Pseudocoma States
Management
Emergency Treatments for Patients in Coma
General Care of the Comatose Patient
Prognosis and Outcome
Chapter 6: Acute Stroke
Phone call
Questions
Orders
Elevator thoughts
Major threat to life
Bedside
Quick-Look Test
Airway and Vital Signs
Selective History
Selective Physical Examination
General Physical Examination
Neurologic Examination
Management
Acute Management
Hemorrhage
Radiographic Assessment
Checklist for Acute Management of Intracerebral Hemorrhage
Infarction
Radiographic Assessment
Goals of Management
Secondary Prevention and Hospital Management of Ischemic Stroke
Management II: General Care
Chapter 7: Spinal Cord Compression
Phone call
Questions
Orders
Inform RN
Elevator thoughts
Major threat to life
Bedside
Quick-Look Test
Management
Selective Physical Examination
General Physical Examination
Neurologic Examination
Selective History and Chart Review
Surgical Intervention
Chapter 8: Delirium and Amnesia
Phone call
Questions
Orders
Inform RN
Elevator thoughts
Major threat to life
Bedside
Quick-Look Test
Selective Physical Examination I
General Physical Examination
Neurologic Examination
Selective History and Chart Review
Management
Control of Delirium
Treatment of Life-Threatening Disorders
Selective History and Chart Review
Treatment of Other Disorders
Other Amnestic Disorders
Transient Global Amnesia
Thiamine Deficiency Encephalopathies: Wernicke Encephalopathy and Korsakoff Syndrome
Chapter 9: Head Injury
Phone call
Questions
Determination of the Severity of Injury
Orders
Elevator thoughts
Major threat to life
Bedside
Quick-Look Test
Airway and Vital Signs
Selective Physical Examination
General Physical Examination
Neurologic Examination
Management
Minimal-Risk Group
Moderate-Risk Group
Severe Head Injury
Checklist for management of severe head injury in the neuro-intensive care unit
Selected complications of severe head injury
Prognosis
Chapter 10: Focal Mass Lesions
Introduction
Phone call
Questions
Orders
Elevator thoughts
Differential Diagnosis of Focal Intracranial Mass Lesions
Neoplasms
Infections
Inflammatory Diseases
Major threats to life
Bedside
Focused History
Selective Physical Examination
General Physical Examination
Neurologic Examination
Further Diagnostic Workup
Management
Chapter 11: Gait Failure
Phone call
Questions
Orders
Elevator thoughts
Major threat to life
Bedside
Quick-Look Test
Selective History and Chart Review
Selective Physical Examination I
General Physical Examination
Neurologic Examination
Management
Selective Physical Examination II
Diagnostic Testing
Laboratory investigation
Other Diagnostic Tests
Treatment of Some of the Reversible Causes of Ataxia
Chapter 12: Acute Visual Disturbances
Phone call
Questions
Orders
Inform RN
Elevator thoughts
Major threat to life
Bedside
Quick-Look Test
Selective History and Chart Review
Selective Physical Examination
General Physical Examination
Neurologic Examination
Management
Chapter 13: Increased Intracranial Pressure
Phone call
Questions
Bedside
Quick-Look Test
Management I
Emergency Measures for Reduction of Intracranial Pressure
Placement of an Intracranial Pressure Monitor
Intracranial Pressure Monitors
Elevator thoughts
Intracranial Anatomy
Intracranial Compliance
Cerebral Perfusion Pressure
Intracranial Pressure Waveforms
Management II
General Measures for Treating Patients with Increased Intracranial Pressure
Steps for Treating an "Intracranial Pressure Crisis" in an Intubated, Monitored Patient
Tier I Interventions: What to Do First
Tier II: Navigating Intracranial Pressure Crisis
Tier III: Salvage Interventions
Chapter 14: Dizziness and Vertigo
Phone call
Questions
Orders
Inform RN
Elevator thoughts
Major threat to life
Bedside
Quick-Look Test
Selective History and Chart Review
Selective Physical Examination
General Physical Examination
Neurologic Examination
Management
Chapter 15: Headache
Phone call
Questions
Orders
Elevator thoughts
Primary Headache Disorders
Secondary Headache Disorders
Painful Cranial Neuropathies and Other Facial Pain
Major threat to life
Bedside
Quick-Look Test
Airway and Vital Signs
Selective History and Chart Review
Selective Physical Examination
Selective Neurologic Examination
Diagnostic Testing
Management
Migraine
Migraine Without Aura
Migraine With Aura
Chronic Migraine
Status Migrainosus
Treatment
Tension-Type Headache
Treatment
Medication-Overuse Headache
Cluster Headache and Other Trigeminal Autonomic Cephalalgias
Treatment
Hemicrania Continua
Treatment
Posttraumatic Headache
Treatment
Idiopathic Intracranial Hypertension
Treatment
Spontaneous Intracranial Hypotension
Treatment
Giant Cell Arteritis
Treatment
Chapter 16: Neuromuscular Respiratory Failure
Phone call
Questions
Orders
Elevator thoughts
Major threat to life
Bedside
Quick-Look Test
Airway and Vital Signs
Selective History
Selective Physical Examination
General Physical Examination
Neurologic Examination
Management
Airway Management and Mechanical Ventilation
Criteria for Intubation
Initial Ventilator Management
Bronchoscopy
Tracheostomy
Weaning to Extubation
General Care of the Patient With Neuromuscular Respiratory Failure
Specific Disorders
Guillain-Barré Syndrome
Onset
Clinical features
Laboratory data
Treatment
Prognosis
Myasthenia Gravis
Clinical features
Laboratory data
Treatment
Uncommon Causes of Paralysis and Respiratory Failure
Botulism
Poliomyelitis
Acute Flaccid Myelitis
Tetanus
Chapter 17: Syncope
Phone call
Questions
Orders
Elevator thoughts
Major threat to life
Bedside
Quick-Look Test
Airway and Vital Signs
Selective History
Selective Physical Examination
General Physical Examination
Management
Chapter 18: Pain Syndromes
Phone call
Questions
Orders
Inform RN
Elevator thoughts
Major threat to life
Bedside
Quick-Look Test
Vital Signs
Selective History and Chart Review
Selective Physical Examination I
General Physical Examination
Neurologic Examination
Management
Selected Pain Syndromes
Complex regional pain syndrome types 1 and 2 (type 1: AKA reflex sympathetic dystrophy, type 2: AKA causalgia)
Clinical Presentation
Diagnosis
Treatment
Trigeminal neuralgia (TIC douloureux)
Clinical Presentation
Diagnosis
Treatment
Herpetic neuralgia (shingles), postherpetic neuralgia
Clinical Presentation
Diagnosis
Treatment
Peripheral neuropathy
Clinical Presentation
Diagnosis
Treatment
Cervical or lumbosacral root compression
Clinical Presentation
Diagnosis
Treatment
Brachial neuritis (idiopathic brachial plexopathy, neuralgic amyotrophy, brachial neuralgia, parsonage-turner syndrome)
Clinical Presentation
Diagnosis
Treatment
Chapter 19: Brain Death
Clinical Significance of Brain Death
Clinical Guidance
Criteria for the Clinical Diagnosis of Brain Death
Confirmatory Testing
Psychosocial Issues
Intensive Care Unit Management of Potential Organ Donors
Protocol for Management of the Potential Organ Donor in the Intensive Care Unit
Selected Neurologic Disorders
Chapter 20: Nerve and Muscle Diseases
Approach to the Patient With Suspected Neuromuscular Disease
History
Examination
Motor Neuron Disease
Amyotrophic Lateral Sclerosis (ALS)
Spinal muscular atrophy
Multifocal motor neuropathy
Other motor neuron diseases
Diagnosis
Treatment
Monoradiculopathy and Polyradiculopathy
Plexopathy
Brachial Plexopathy
Lumbosacral Plexopathy
Diagnosis
Treatment
Mononeuropathies
Carpal Tunnel Syndrome
Diagnosis
Treatment
Facial Palsy (Bell Palsy)
Diagnosis
Treatment
Other Common Nerve Entrapment Syndromes
Mononeuropathy Multiplex
Diagnosis
Treatment
Polyneuropathy
Clinical Approach to the Patient with Polyneuropathy
Diagnosis
Management
Laboratory Testing for Evaluation of Polyneuropathy
Selected Causes of Neuropathy
General Care of the Patient with Neuropathy
Neuromuscular Junction Disease
Myopathy
Questions to Ask the Patient with Suspected Myopathic Disease
Examination
Management
Diagnostic Testing
Causes of Myopathy
Chapter 21: Demyelinating and Inflammatory Disorders of the Central Nervous System
Multiple Sclerosis
General Considerations
Epidemiology
Genetics
Pathology
Clinical Features
Symptomatic Onset
Sensory Disturbance
Optic Neuritis
Motor Symptoms
Diplopia
Ataxia and Tremor
Neuropsychiatric Dysfunction
Bladder and Bowel Dysfunction
Vertigo
Dysarthria
Dysphagia
Facial Weakness
Fatigue
Paroxysmal Symptoms
Disease Course
Relapsing-Remitting Multiple Sclerosis
Secondary Progressive Multiple Sclerosis
Primary Progressive Multiple Sclerosis
Diagnosis
Magnetic Resonance Imaging
Cerebrospinal Fluid
Evoked Potentials
Rating Scales
Differential Diagnosis of MS
Progressive Myelopathy
Progressive Cognitive Impairment With Symmetric White Matter Disease
Cranial Neuropathies
Disease-Modifying Therapies
Interferons
Glatiramer Acetate
Mitoxantrone
Natalizumab
Fingolimod
Teriflunomide
Dimethyl Fumarate
Alemtuzumab
Ocrelizumab
Glucocorticoids
Plasma Exchange
Treatments for SPMS
Off-Label Immunomodulatory Agents
Symptomatic Therapies
Spasticity
Fatigue
Pain
Paroxysmal Symptoms
Bladder Dysfunction
Bowel Dysfunction
Sexual Dysfunction
Acute Transverse Myelitis
Neuromyelitis Optica Spectrum Disorder
Acute Multiple Sclerosis
Acute Disseminated Encephalomyelitis
Neuro Sarcoidosis
Diagnosis
Management
Behçet Disease
Diagnosis
Management
Central Pontine Myelinolysis
Chapter 22: Infections of the Central Nervous System
Approach to the Patient With Suspected Central Nervous System Infection
Historical Features
Examination Features
Lumbar Puncture
Acute Meningitis
Acute Bacterial Meningitis
Etiologies
Laboratory Diagnosis
Treatment
Viral (Aseptic) Meningitis
Etiologies
Laboratory Diagnosis
Chronic Meningitis
Tuberculosis Meningitis
Diagnosis
Treatment
Neurosyphilis
Diagnosis
Treatment
Lyme Disease
Diagnosis
Treatment
Fungal Meningitis
Diagnosis
Treatment
Brain Abscess and Parameningeal Infections
Bacterial Abscess
Diagnosis
Treatment
Subdural Empyema
Cranial and Spinal Epidural Abscess
Cysticercosis
Diagnosis
Treatment
Viral Encephalitis
Herpes Simplex Encephalitis
Diagnosis
Treatment
West Nile Virus Infection
Diagnosis
Treatment
Other Causes of Encephalitis
Viral Myelitis
Acute Viral Myelitis
Diagnosis
Treatment
Chronic Viral Myelopathy
Diagnosis
Treatment
Neurologic Complications of AIDS
Opportunistic Infections
Nonopportunistic Nervous System Complications of AIDS
Chapter 23: Neurooncology
Symptomatic Management in Neurooncology
Corticosteroids
Antiepileptic Drugs
Anticoagulants
Gliomas
Epidemiology
Diagnosis
Treatment
Newly Diagnosed Gliomas
Surgery
Radiotherapy
Chemotherapy
Tumor-Treating Fields
Recurrent Gliomas
Prognosis
Primary Central Nervous System Lymphoma
Epidemiology
Diagnosis
Treatment
Prognosis
Meningiomas
Epidemiology
Etiology
Diagnosis
Treatment
Active Surveillance
Surgery
Radiotherapy
Medical Therapy
Prognosis
Brain Metastases
Epidemiology
Diagnosis
Treatment
Prognosis
Leptomeningeal Metastases
Diagnosis
Treatment
Prognosis
Metastatic Epidural Spinal Cord Compression
Diagnosis
Treatment
Prognosis
Pituitary Adenoma
Epidemiology
Pathology
Presentation
Diagnosis
Treatment
Prognosis
Acoustic Neuroma
Epidemiology
Presentation
Diagnosis
Treatment
Chapter 24: Cerebrovascular Disease
Classification
Subarachnoid hemorrhage
Clinical Presentation
Diagnosis
Management
Surgery
Endovascular Embolization
Medical Management
Treatment of Vasospasm
Ischemic stroke
Clinical Presentation and Diagnosis
Cardioembolic Stroke
Large-Vessel Stenosis
Artery-to-Artery Embolus
Lacunar Stroke (Small-Vessel Disease)
Other Etiologies
Management
Intracerebral hemorrhage
Clinical Presentation
Diagnosis
Management
Chapter 25: Movement Disorders
Basic Principles
Step 1: Observe
Step 2: Describe
Step 3: Classify
Step 4: Give The Movement a Name
Step 5: Diagnose a Specific Disease
Parkinson Disease
Types of Movements
Diagnostic Tests
Treatment
Levodopa
Dopamine Agonists
Amantadine
Anticholinergics
Comt Inhibitors
Mao-B Inhibitors
Essential Tremor
Types of Movements
Diagnostic Tests
Treatment
Beta Blockers
Medications That Enhance Gaba-Ergic Tone
Huntington Disease
Types of Movements
Diagnostic Tests
Management
Idiopathic Torsion Dystonia (Dystonia Musculorum Deformans)
Types of Movements
Diagnostic Tests
Management
Tourette Syndrome
Types of Movements
Diagnostic Tests
Management
Wilson Disease
Types of Movements
Diagnostic Tests
Management
Restless Leg Syndrome
Types of Movements
Diagnostic Tests
Treatment
Miscellaneous Disorders
Chapter 26: Epilepsy and Seizure Disorders
Introduction
Definitions
Seizure Classification
Generalized seizures
Generalized Tonic-Clonic ("Grand Mal") Seizures
Absence ("Petit Mal") Seizures
Myoclonic Seizures
Tonic Seizures
Atonic Seizures
Focal (Partial) Seizures
Focal Seizures Without ("Simple Partial Seizures") or With Impairment of Awareness ("Complex Partial Seizures")
Temporal Lobe Seizures
Frontal Lobe Seizures
Occipital Lobe Seizures
Parietal Lobe Seizures
Seizures of Unknown Onset
Infantile (Epileptic) Spasms
Epilepsy Syndromes
Idiopathic Generalized Epilepsy Syndromes
Childhood Absence Epilepsy
Juvenile Absence Epilepsy
Juvenile Myoclonic Epilepsy
Epilepsy With Generalized Tonic-Clonic Seizures on Awakening
Symptomatic Generalized Epilepsy Syndromes
West Syndrome (Infantile Spasms)
Lennox-Gastaut Syndrome
Idiopathic Localization-Related Epilepsy Syndromes
Benign Childhood Epilepsy With Centrotemporal Spikes ("Benign Rolandic Epilepsy")
Childhood Occipital Epilepsy With Occipital Paroxysms
Febrile seizures
The First Seizure
Seizure "Mimics"
Provoked Seizures
Traumatic Brain Injury
Alcohol
Stroke
Investigating the First Seizure
Risk of Recurrence
Seizures and Safety
Treatment
Pharmacologic Treatment
General Principles
Choice of Antiepileptic Drug Depending on Epilepsy Syndrome and Seizure Type
Side Effects and Comorbidities
Drug Interactions
Special Considerations in Women With Epilepsy
Dietary Therapy
Surgical Treatment
Focal Resection
Other Neurosurgical Options
Neurostimulation for Epilepsy
Chapter 27: Pediatric Neurology
Birth Trauma
Birth Injury of the Brachial Plexus
Spinal Cord Injury
Tentorial Subdural Hematoma
Hypotonic Newborn
Cerebrovascular Complications of Prematurity
Periventricular Hemorrhagic Infarction
Periventricular Leukomalacia
Neonatal Seizures
Treatment
Infantile Spasms
Febrile Seizures
Diagnosis
Treatment
Disorders That Resemble Seizures
Infections of the Central Nervous System
Diagnostic Evaluation
Diagnosis
Treatment of Central Nervous System Infections
Fulminant Encephalopathies of Infancy and Childhood
Acute Disseminated Encephalomyelitis (ADEM)
Multiple Sclerosis (MS)
Postinfectious Cerebellitis
Neuromyelitis Optica (NMO)
Acute Toxic Encephalopathy
Pediatric Stroke
Ventriculoperitoneal Shunt Malfunction
Tumors
Head Injury
Child Abuse
Brain Death
Chapter 28: Dementia
Examination of the Demented Patient
Primary Neurodegenerative Disorders
Alzheimers Disease
Risk Factors
Clinical Presentation
Diagnosis
Treatment
Lewy Body Dementias
Diffuse Lewy Body (DLB) Disease
Parkinson Disease Dementia (PDD)
Frontotemporal Dementia (FTD)
Behavioral Frontotemporal Dementia
Primary Progressive Aphasia (PPA)
Semantic Dementia (CD)
Progressive Supranuclear Palsy (PSP)
Cortical Basal Ganglionic Degeneration (CBD)
Treatment of Frontotemporal Dementia Syndromes
Huntington Disease
Other Dementia Disorders
Vascular Dementia
Normal Pressure Hydrocephalus
Creutzfeldt-Jakob Disease
Immune-Mediated Encephalitidies
Vitamin B12 Deficiency
HIV-Associated Dementia (Aids Dementia Complex)
Wernicke-Korsakoff Syndrome
Transient Global Amnesia
Appendix A: Muscles of the Neck and Brachial Plexus
Appendix B:Muscles of the Perineum and Lumbosacral Plexus
Appendix C: Brachial Plexus
Appendix D: Lumbar Plexus
Appendix E: Sensory Dermatome Map
Appendix F: Surface Map of the Brain
Appendix G: Nuclei of the Brain Stem
Appendix H: Surface Anatomy of the Brain Stem
On-Call Formulary: Commonly Prescribed Medications in Neurology
Index
Inside Back Cover