Key Concepts Patients who present with predominant symptoms of anxiety may be suffering from medical disorders, medication effects, or substance abuse or withdrawal. Anxiety may accompany the onset of serious medical disease, cause significant metabolic demands, and stress a marginally…
Key Concepts Patients with apparent mood disorders should be evaluated for medical disorders, medication effects, or substance abuse or withdrawal because these conditions can mimic both depression and mania. Mood disorders should be suspected in patients with multiple, vague, nonspecific…
Key Concepts Thought disorder symptoms can be precipitated by psychiatric, underlying medical, and toxicologic etiologies. Diagnostic testing should be patient specific and based on the particular medical processes that the clinician feels may be causing or exacerbating the thought disorder,…
Key Concepts CNS infection should be considered in all patients with headache, nuchal rigidity, fever, altered sensorium, or diffuse or focal neurologic findings. Patients with suspected CNS infection should be asked about history focused on risk factors for CNS disease…
Key Concepts In patients presenting with acute neuromuscular weakness, complaints of difficulty in breathing or swallowing are signs of bulbar nerve or respiratory muscle compromise with potential airway or ventilatory failure. In such patients, forced vital capacity (FVC) of less…
Key Concepts The diagnosis of a specific peripheral neuropathy generally requires confirmatory ancillary testing; approach in the ED should focus on identifying one of seven categorical patterns. Diagnostic approach to peripheral neuropathies involves combining three clinical features: (1) right-left symmetry…
Key Concepts Nontraumatic spinal cord disorders can be intrinsic or extrinsic, some of which require prompt diagnosis, advanced imaging, and specialist intervention to prevent or limit permanent neurologic dysfunction. The bulbocavernosus reflex is cord-mediated. Return of this reflex following a…
Key Concepts Multiple Sclerosis The clinical picture of multiple sclerosis (MS); is one of marked heterogeneity. The classic clinical syndrome consists of recurring episodes of neurologic symptoms that rapidly evolve over days and slowly resolve over weeks. Magnetic resonance imaging…
Key Concepts Delirium is an acute condition characterized by an altered level of attention and awareness. It develops during a short time, and symptoms tend to fluctuate throughout the day. Delirium is commonly caused by medications, drug intoxication or withdrawal,…
Headache is divided into primary and secondary disorders. Key Concepts The goals of headache evaluation in the ED are (1) to distinguish between benign primary headache disorders and potentially life-threatening secondary causes of headache and (2) to treat the headache…