The term delirium is synonymous with the term acute confusional state . Delirium is common in hospitalized patients, particularly in the elderly, and refers to an acute, global disorder of thinking and perception, characterized by impaired consciousness and inattention. Restlessness,…
Spinal cord compression is one of the few true neurologic emergencies. The more severe the syndrome, the more acute the injury is likely to have been. Unlike the brain, which may have remarkable functional recovery, the spinal cord, once damaged,…
Stroke should be suspected whenever a patient presents with the characteristic sudden onset of focal neurologic signs such as hemiparesis, hemisensory loss, hemianopia, aphasia, or ataxia ( Table 6.1 ). Time is of the essence for treating stroke because reperfusion…
Stupor and coma refer, respectively, to moderate and severe depression of the level of consciousness. The acute onset of stupor or coma is a medical emergency. A wide variety of metabolic and structural disorders can produce this state. Management should…
Seizures are abnormal, paroxysmal synchronous discharges of cortical neurons resulting in abrupt neurologic manifestations that depend on the area of the brain involved. Seizures are classified as generalized ( Fig. 4.1 ) when they involve the entire brain, producing an…
A thorough history and examination should enable you to localize the disease process and generate a differential diagnosis. Confirmation of the diagnosis will usually require neurodiagnostic testing. When any of the tests described here is performed, it is essential to…
Clinical examination is of primary importance in the practice of neurology, even with the availability of advanced neuroimaging techniques. This is because the neurologic examination provides critical information that no other test can provide, such as whether the patient’s nervous…
It is in the early morning hours. You get a call from a resident in the emergency room (ER). A 48-year-old teacher has headache, neck pain, and urinary incontinence, and, as of this morning, is no longer able to hold…