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…
Mood and psychotic disorders account for a substantial burden of mental disease. These disorders are often first evaluated in primary care offices or emergency departments. This chapter will focus on a selection of these commonly encountered disorders: major depressive disorder,…
Neuromyelitis Optica (Devic Disease) and Neuromyelitis Optic Spectrum Disorder Clinical Vignette A 58-year-old woman was admitted to the hospital with a 5-day history of numbness and weakness in both lower extremities, a tight bandlike sensation across her chest associated with…
Incidence Multiple sclerosis (MS) is the most common chronic disabling immunologic disease of the central nervous system among young people, typically presenting in the third to fifth decades of life, affecting women more than men. It is estimated that approximately…
Clinical Vignette A 70-year-old woman presented with a 2-year history of gait slowness and unsteadiness. She sustained several falls, usually backward. She began using a cane 1 year ago. She has noticed difficulty standing up or getting out of her…