Lower back pain is one of the most common reasons for neurological and neurosurgical consultation. In many of the patients who present with lower back pain, the pain either developed or was exacerbated as a result of occupational activity. Lower…
Evaluation of the patient with arm and/or neck pain is based on a meticulous history and clinical examination. A useful approach is to consider the diagnosis in terms of pain-sensitive structures in the neck and upper limbs. These structures may…
Clinical evaluation of sensory deficits is inherently more difficult than evaluation of motor deficits because of the subjective nature of the examination. Nevertheless, it is important to identify sensory deficits in order to localize lesions. Anatomy and Physiology Peripheral Pathways…
A floppy, or hypotonic, infant is a common scenario encountered in the clinical practice of child neurology. It can present significant challenges in terms of localization and is associated with an extensive differential diagnosis ( Box 30.1 ). As with…
General Features of Pain Pain is an uncomfortable sensation with sensory and emotional components. Short episodes of pain or discomfort localized to muscle are a near universal experience. Common causes of short-term muscle discomfort are unaccustomed exercise, trauma, cramps, and…
Muscle weakness may be due to disorders of the central nervous system (CNS) or peripheral nervous system (PNS). The PNS includes the primary sensory neurons in the dorsal root ganglia, nerve roots, peripheral nerves, neuromuscular junctions, and muscles. Although not…
Paraplegia and quadriplegia may result from a variety of systemic and primary central nervous system medical conditions as well as trauma at all segmental levels of the spinal cord ( Box 27.1 ). A spinal cord syndrome may develop from…
Hemiplegia and monoplegia are more likely to be due to discrete focal lesions than diffuse lesions, so these presentations are especially suited to clinical-anatomical localization. Similarly, imaging studies are likely to be revealing with hemiplegia or monoplegia, but the focus…
The maintenance of an upright posture and the act of walking are among the first and ultimately most complex motor skills humans acquire. From an early age, walking skills are modified and refined. In later years, the interplay between voluntary…
The term movement disorders is often used synonymously with basal ganglia or extrapyramidal diseases . However, neither of the two latter terms adequately encompasses all the disorders included under the broad umbrella of movement disorders. Movement disorders are neurological motor…