Paraneoplastic neurologic disorders are seen when antitumor immunologic responses, primarily antibodies, directed against antigens expressed in the cancer, attack neural cells (neurons or glia) also expressing these antigens. Based on the neurologic presentation and the antibody profile, there are numerous…
The most common spinal cord tumors are metastatic extradural lesions most commonly occurring in patients with already identified systemic cancers. Their presentation is often relatively acute, usually associated with focal back and/or radicular pain. On occasion, these lesions are the…
Clinical Vignette A 47-year-old self-employed father presented to the emergency department having difficulty discriminating coins in his pocket. He had been skiing that day and was concerned enough to seek medical attention on his way home. His general health was…
Immunocompromised hosts are susceptible to a wide range of neurologic infections, which include both opportunistic infections and those typically found in normal hosts. The risk for particular infections is related to a number of factors including the type of immune…
Sarcoidosis is a multisystem granulomatous autoinflammatory disorder that typically affects lungs, lymph nodes, and skin. The nervous system is involved in 5% to 20% of patients with sarcoidosis. Neurosarcoidosis (NS) has a predilection for the meninges (resulting in cranial neuropathies…
Parasitic infections of the nervous system range from acute syndromes such as diffuse cerebritis in cerebral malaria to more chronic mass lesions causing seizure disorders such as neurocysticercosis. This chapter will focus on the most common parasites causing central nervous…
Herpes Simplex Encephalitis Clinical Vignette An independent 74-year-old man left a family wedding reception early because he did not feel well; he complained of mild nausea and general malaise. His daughter called the next day, and when he did not…
Common Syndromes Bacterial Meningitis Clinical Vignette A 19-year-old woman presented to the emergency department with confusion, lethargy, and neck stiffness. Her dorm mates reported that she had experienced upper respiratory symptoms for 3 or 4 days before presentation. She had…
Clinical Vignette A 73-year-old woman is seen in the emergency department after an unwitnessed fall at home in which her husband heard a crash and found her moments later on the ground in her bedroom. She was disoriented and bleeding…
The recognition and treatment of mental disorders are not confined to the specialty of psychiatry. Neuropsychiatric symptoms can mimic those of nonpsychiatric disorders that bring the patient to the attention of the nonpsychiatrist. This chapter reviews a number of important…