Physical Address

304 North Cardinal St.
Dorchester Center, MA 02124

Visual Analysis of the EEG:: Wakefulness, Drowsiness, and Sleep

An orderly approach to visual analysis of the EEG is important, especially for those who are beginning to hone their EEG reading skills. Although not all EEG records necessarily lend themselves to a single reading approach, it is useful to start the process of record interpretation with a preplanned analysis strategy that is based on the findings of a typical EEG, such as the EEG of…

Lumbar Plexus

You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Dementia

Memory dysfunction may be variable in its presentation and ranges from the highly functioning senior citizen complaining of forgetfulness to the patient brought in by a relative for bizarre behavior and confusion. Amnesia is defined as a pure loss of memory without other cognitive dysfunction. Dementia implies chronic, progressive cognitive loss including chronic loss of memory to a degree sufficient to interfere with occupational or social…

Pediatric Neurology

A developmental, social, and family history should be obtained for every pediatric patient seen as an emergency. The guardians’ understanding of any preexisting diseases and of the cause of the current events also should be elicited. At first glance, determine the degree of neurologic compromise by estimating the level of alertness of the child and the need for rapid intervention. Then, direct the interview toward assessing…

Epilepsy and Seizure Disorders

Introduction Epilepsy, seizures, and related disorders are among the most commonly encountered problems in neurologic practice. Diagnosis and treatment of these disorders can be challenging for even the most experienced physicians, and for patients, these disorders can be the source of significant morbidity, emotional distress, and disability. This chapter will provide an overview to the diagnosis, differential diagnosis, and management of epilepsy and related disorders. Definitions…

Movement Disorders

Movement disorders may be defined simply as abnormal involuntary (i.e., uncontrollable) movements. These movements are not the result of weakness or sensory deficits. Rather, they are generally the result of dysfunction of what may be defined anatomically as either the basal ganglia or cerebellum and functionally as the extrapyramidal motor system. The diversity of movement disorders can be overwhelming, with movements including those that are commonly…

Cerebrovascular Disease

Cerebrovascular disease includes a wide spectrum of disorders, all sharing an acquired or inherited pathology of the cerebral vasculature. Stroke syndromes range in scope from a minor hemisensory loss in a single limb to hemiplegia, cognitive changes, and coma. The onset of deficits usually occurs in seconds to minutes. The physical examination can give an impression of the size and a fair estimate of the location…

Neurooncology

Tumors of the central nervous system (CNS) are a significant cause of morbidity and mortality. In the United States, it is estimated that 22,000 new cases and 13,000 deaths caused by primary malignant CNS malignancies occur annually. Additionally, 28,000 new cases of meningiomas, which are more than 90% benign tumors, are diagnosed each year. Metastatic CNS tumors significantly outnumber primary tumors; an estimated 170,000 cases of…

Infections of the Central Nervous System

There are a broad number of organisms that can cause damage to the central or peripheral nervous system, either directly or indirectly. These conditions are often life-threatening. Diagnosis can be challenging because patients often present with nonspecific clinical syndromes that can be caused by infectious and noninfectious causes. Prompt diagnosis and treatment are essential to prevent death or permanent neurologic disability. The combination of fever, headache,…

Demyelinating and Inflammatory Disorders of the Central Nervous System

Demyelinating and inflammatory diseases of the central nervous system (CNS) are varied and often enigmatic. Multiple sclerosis ( MS), the prototypical inflammatory demyelinating disease, is a chronic autoimmune disorder characterized by loss of myelin and relative preservation of axons. Acute disseminated encephalomyelitis (ADEM) is a monophasic illness that is pathologically similar to MS but is typically triggered by an antecedent viral infection. Central pontine myelinolysis (CPM)…

Nerve and Muscle Diseases

Patients with neuromuscular disease generally present with weakness, sensory loss, or both of these conditions. Your approach should initially focus on localizing the problem to a specific component of the peripheral nervous system that is involved (e.g., neuropathy or myopathy) and then be directed toward identifying a specific disease process. The major anatomic components of the peripheral nervous system are listed in Table 20.1 . Table…

Brain Death

The Uniform Determination of Death Act (UDDA) of 1981 defined death in two ways: (1) there is the traditional definition of death involving the irreversible cessation of circulatory and respiratory function; and (2) there is the irreversible cessation of all function of the entire brain including the brain stem, which defines brain death. The concept of brain death did not exist before the era of modern…