简介
Summary:
Publisher Summary 1
This is a clinical neurology book for聽students and non neurologists, and for聽those聽who teach them. The book covers neuroanatomy, history taking and examination and then proceeds to discuss the clinical features of common problems as well as聽selected, less common聽neurological disorders, in a way that will demystify a part of medicine that many find complex and difficult to understand. The book is accompanied by a DVD explaining concepts, demonstrating techniques of performing the neurological examination and demonstration of abnormal neurological signs.The first chapter is devoted to neuroanatomy from a clinical viewpoint. The concept of localising problems by likening the nervous system to a map grid with vertical meridians of longitude (the ascending sensory pathways and the descending motor pathway)and horizontal parallels of latitude (cortical signs, brainstem cranial nerves, nerve roots and peripheral nerves) of the nervous system is developed. Subsequent chapters take the reader through the neurological examination and the common neurological presentations from a symptom oriented approach. Chapter 4 contains a very simple method of understanding the brainstem, the "rule of 4". Chapter 6 discusses the approach after the history and examination are completed. The final chapter is an overview of how to approach information gathering and keeping up-to-date using the complex information streams available.Reviews of Clinical Neurology -"I would strongly recommend this book to anyone who's looking for a book to introduce them to the field of neurology, and to anyone thats needs a quick refresher on neurological presentations. I have thoroughly enjoyed reading this book, gained plenty of new information, and have developed new ways of accessing neurological presentations."聽 Review by Kane Guthrie Google Preview".we may be seeing the birth of a new classic educational and training neurology textbook. I recommend it highly." Review by Neil Scolding, Burden Professor of Clinical Neurosciences - practical-neurology.com"Dr Gates has somehow deconstructed what a neurologist does and laid this bare for us to see. The result is a text of enormous utility to medical students, postgraduate students and importantly teachers of those students" Review by M. Leech - Internal Medicine Journal
widely illustrated with case studies and illustrationskey pointsclinical questionsclinical orientation with comprehensive references
Publisher Summary 2
This is a clinical neurology book for students and non neurologists, and for those who teach them. The book covers neuroanatomy, history taking and examination and then proceeds to discuss the clinical features of common problems as well as selected, less common neurological disorders, in a way that will demystify a part of medicine that many find complex and difficult to understand. The book is accompanied by a DVD explaining concepts, demonstrating techniques of performing the neurological examination and demonstration of abnormal neurological signs.The first chapter is devoted to neuroanatomy from a clinical viewpoint. The concept of localising problems by likening the nervous system to a map grid with vertical meridians of longitude (the ascending sensory pathways and the descending motor pathway)and horizontal parallels of latitude (cortical signs, brainstem cranial nerves, nerve roots and peripheral nerves) of the nervous system is developed. Subsequent chapters take the reader through the neurological examination and the common neurological presentations from a symptom oriented approach. Chapter 4 contains a very simple method of understanding the brainstem, the "rule of 4". Chapter 6 discusses the approach after the history and examination are completed. The final chapter is an overview of how to approach information gathering and keeping up-to-date using the complex information streams available.
widely illustrated with case studies and illustrationskey pointsclinical questionsclinical orientation with comprehensive references
目录
Table Of Contents:
Foreword ix
Preface xi
Acknowledgements xiii
Reviewers xv
1 Clinically Oriented Neuroanatomy: `Meridians of Longitude and Parallels of Latitude' 1(30)
Concept of the meridians of longitude and parallels of latitude 2(2)
The meridians of longitude: localising the problem according to the descending motor and ascending sensory pathways 4(7)
The parallels of latitude: finding the site of pathology within the structures of the central and peripheral nervous systems 11(20)
2 The Neurological History 31(13)
Principles of neurological history taking 33(1)
The underlying pathological process: mode of onset, duration and progression of symptoms 33(2)
The nature and distribution of symptoms 35(6)
Past history, family history and social history 41(1)
The process of taking the history 42(2)
3 Neurological Examination of the Limbs 44(25)
The motor examination 44(16)
The sensory examination 60(5)
Examining cerebellar function 65(1)
Clinical cases 66(3)
4 The Cranial Nerves and Understanding the Brainstem the `Rule of 4' 69(27)
The olfactory nerve 69(1)
The optic nerve, chiasm, radiation and the occipital cortex 69(4)
The 3rd, 4th and 6th cranial nerves 73(4)
Control of eye movements, the pupil and eyelid opening: sympathetic and parasympathetic innervation of the pupil and eyelid 77(2)
The trigeminal (5th) nerve 79(2)
The facial (7th) nerve 81(2)
The auditory/vestibular (8th) nerve 83(1)
The glossopharyngeal (9th) nerve 83(2)
The vagus (10th) nerve 85(1)
The accessory (11th) nerve 86(1)
The hypoglossal (12th) nerve 86(1)
The `Rule of 4' of the brainstem 87(9)
5 The Cerebral Hemispheres and Cerebellum: Assessment of Higher Cognitive Function 96(14)
The frontal lobes 96(2)
The parietal lobes 98(7)
The occipital lobes 105(1)
The cerebellum 105(1)
The temporal lobes 106(1)
Testing higher cognitive function 107(1)
Some rarer abnormalities of higher cognitive function 108(2)
6 After the History and Examination, What Next? 110(12)
Level of certainty of diagnosis 110(5)
Availability of tests to confirm or exclude certain diagnoses 115(2)
The possible complications of tests 117(1)
Severity and urgency: the potential consequences of a particular illness not being diagnosed and treated 118(1)
The benefit versus risk profile of any potential treatment 119(1)
Social factors and past medical problems that may influence a course of action or treatment 120(2)
7 Episodic Disturbances of Neurological Function 122(24)
The history and intermittent disturbances 122(5)
General principles of classification of intermittent disturbances 127(1)
Episodic disturbances with falling 128(3)
Falling without loss of consciousness 131(2)
Episodic disturbances without falling 133(13)
8 Seizures and Epilepsy 146(22)
Clinical features characteristic of epilepsy 146(1)
The principles of management of patients with a suspected seizure or epilepsy 147(1)
Confirming that the patient has had a seizure or suffers from epilepsy 147(3)
Characterisation of the type of seizure 150(6)
Assessing the frequency of seizures 156(1)
Identifying any precipitating causes 156(1)
Establishing an aetiology 157(1)
Deciding whether to treat or not 158(1)
Choosing the appropriate drug, dose and ongoing monitoring of the response to therapy 159(1)
Advice regarding lifestyle 160(2)
Consideration of surgery in patients who fail to respond to drug therapy 162(1)
Whether and when to withdraw therapy in `seizure-free' patients 163(1)
Common treatment errors 163(1)
The electroencephalogram 164(4)
9 Headache and Facial Pain 168(33)
What questions to ask 170(5)
A single (or the first) episode of headache 175(7)
Recurrent headaches 182(9)
When to worry 191(1)
Investigating headache 192(1)
Facial pain 193(8)
10 Cerebrovascular Disease 201(31)
Minor stroke or transient ischaemic attack does the definition matter? 201(1)
Principles of management 202(1)
Deciding the problem is cerebrovascular disease 203(2)
Differentiating between haemorrhage and ischaemia 205(1)
Haemorrhagic stroke 206(2)
Ischaemic cerebrovascular disease 208(7)
Three stroke syndromes that should not be missed 215(1)
Three of the `more common' rarer causes of stroke, particularly in the young 216(2)
Management of ischaemic cerebrovascular disease 218(1)
Management of acute ischaemic stroke 219(3)
Urgent management of suspected TIA or minor ischaemic stroke 222(2)
Secondary prevention 224(2)
Management of patients with anticoagulation-associated intracranial haemorrhage 226(6)
11 Common Neck Arm and Upper Back Problems 232(27)
Neck pain 233(2)
Problems around the shoulder and upper arm 235(7)
Problems in the forearms and hands 242(17)
12 Back Pain and Common Leg Problems With or Without Difficulty Walking 259(22)
Back pain 259(1)
Problems in the upper leg 260(4)
Problems in the lower legs and feet 264(17)
13 Abnormal Movements and Difficulty Walking Due to Central Nervous System Problems 281(24)
Difficulty walking 281(12)
Abnormal movements 293(12)
14 Miscellaneous Neurological Disorders 305(31)
Assessment of patients with a depressed conscious state 305(5)
Assessment of the confused or demented patient 310(5)
Disorders of muscle and neuromuscular junction 315(8)
Multiple sclerosis 323(3)
Malignancy and the nervous system 326(4)
Infections of the nervous system 330(6)
15 Further Reading, Keeping Up-To-Date And Retrieving Information 336(14)
Keeping up-to-date 336(3)
Retrieving useful information from the Internet 339(3)
General neurology websites 342(1)
Country-based neurology websites 343(1)
Websites related to the more common neurological problems 343(2)
Major neurology journal websites 345(1)
Resources for patients 346(4)
APPENDICES 350(30)
A The Mini-Mental State Examination 351(2)
B Benign focal seizures of childhood 353(2)
C Currently recommended drugs for epilepsy 355(5)
D Treatment of migraine 360(2)
E Epidemiology and primary prevention of stroke 362(7)
F Current criteria for t-PA in patients with ischaemic stroke 369(1)
G Barwon Health Dysphagia Screen 370(3)
H Nerve conduction studies and electromyography 373(5)
I Diagnostic criteria for multiple sclerosis 378(2)
Glossary 380(3)
Index 383
Foreword ix
Preface xi
Acknowledgements xiii
Reviewers xv
1 Clinically Oriented Neuroanatomy: `Meridians of Longitude and Parallels of Latitude' 1(30)
Concept of the meridians of longitude and parallels of latitude 2(2)
The meridians of longitude: localising the problem according to the descending motor and ascending sensory pathways 4(7)
The parallels of latitude: finding the site of pathology within the structures of the central and peripheral nervous systems 11(20)
2 The Neurological History 31(13)
Principles of neurological history taking 33(1)
The underlying pathological process: mode of onset, duration and progression of symptoms 33(2)
The nature and distribution of symptoms 35(6)
Past history, family history and social history 41(1)
The process of taking the history 42(2)
3 Neurological Examination of the Limbs 44(25)
The motor examination 44(16)
The sensory examination 60(5)
Examining cerebellar function 65(1)
Clinical cases 66(3)
4 The Cranial Nerves and Understanding the Brainstem the `Rule of 4' 69(27)
The olfactory nerve 69(1)
The optic nerve, chiasm, radiation and the occipital cortex 69(4)
The 3rd, 4th and 6th cranial nerves 73(4)
Control of eye movements, the pupil and eyelid opening: sympathetic and parasympathetic innervation of the pupil and eyelid 77(2)
The trigeminal (5th) nerve 79(2)
The facial (7th) nerve 81(2)
The auditory/vestibular (8th) nerve 83(1)
The glossopharyngeal (9th) nerve 83(2)
The vagus (10th) nerve 85(1)
The accessory (11th) nerve 86(1)
The hypoglossal (12th) nerve 86(1)
The `Rule of 4' of the brainstem 87(9)
5 The Cerebral Hemispheres and Cerebellum: Assessment of Higher Cognitive Function 96(14)
The frontal lobes 96(2)
The parietal lobes 98(7)
The occipital lobes 105(1)
The cerebellum 105(1)
The temporal lobes 106(1)
Testing higher cognitive function 107(1)
Some rarer abnormalities of higher cognitive function 108(2)
6 After the History and Examination, What Next? 110(12)
Level of certainty of diagnosis 110(5)
Availability of tests to confirm or exclude certain diagnoses 115(2)
The possible complications of tests 117(1)
Severity and urgency: the potential consequences of a particular illness not being diagnosed and treated 118(1)
The benefit versus risk profile of any potential treatment 119(1)
Social factors and past medical problems that may influence a course of action or treatment 120(2)
7 Episodic Disturbances of Neurological Function 122(24)
The history and intermittent disturbances 122(5)
General principles of classification of intermittent disturbances 127(1)
Episodic disturbances with falling 128(3)
Falling without loss of consciousness 131(2)
Episodic disturbances without falling 133(13)
8 Seizures and Epilepsy 146(22)
Clinical features characteristic of epilepsy 146(1)
The principles of management of patients with a suspected seizure or epilepsy 147(1)
Confirming that the patient has had a seizure or suffers from epilepsy 147(3)
Characterisation of the type of seizure 150(6)
Assessing the frequency of seizures 156(1)
Identifying any precipitating causes 156(1)
Establishing an aetiology 157(1)
Deciding whether to treat or not 158(1)
Choosing the appropriate drug, dose and ongoing monitoring of the response to therapy 159(1)
Advice regarding lifestyle 160(2)
Consideration of surgery in patients who fail to respond to drug therapy 162(1)
Whether and when to withdraw therapy in `seizure-free' patients 163(1)
Common treatment errors 163(1)
The electroencephalogram 164(4)
9 Headache and Facial Pain 168(33)
What questions to ask 170(5)
A single (or the first) episode of headache 175(7)
Recurrent headaches 182(9)
When to worry 191(1)
Investigating headache 192(1)
Facial pain 193(8)
10 Cerebrovascular Disease 201(31)
Minor stroke or transient ischaemic attack does the definition matter? 201(1)
Principles of management 202(1)
Deciding the problem is cerebrovascular disease 203(2)
Differentiating between haemorrhage and ischaemia 205(1)
Haemorrhagic stroke 206(2)
Ischaemic cerebrovascular disease 208(7)
Three stroke syndromes that should not be missed 215(1)
Three of the `more common' rarer causes of stroke, particularly in the young 216(2)
Management of ischaemic cerebrovascular disease 218(1)
Management of acute ischaemic stroke 219(3)
Urgent management of suspected TIA or minor ischaemic stroke 222(2)
Secondary prevention 224(2)
Management of patients with anticoagulation-associated intracranial haemorrhage 226(6)
11 Common Neck Arm and Upper Back Problems 232(27)
Neck pain 233(2)
Problems around the shoulder and upper arm 235(7)
Problems in the forearms and hands 242(17)
12 Back Pain and Common Leg Problems With or Without Difficulty Walking 259(22)
Back pain 259(1)
Problems in the upper leg 260(4)
Problems in the lower legs and feet 264(17)
13 Abnormal Movements and Difficulty Walking Due to Central Nervous System Problems 281(24)
Difficulty walking 281(12)
Abnormal movements 293(12)
14 Miscellaneous Neurological Disorders 305(31)
Assessment of patients with a depressed conscious state 305(5)
Assessment of the confused or demented patient 310(5)
Disorders of muscle and neuromuscular junction 315(8)
Multiple sclerosis 323(3)
Malignancy and the nervous system 326(4)
Infections of the nervous system 330(6)
15 Further Reading, Keeping Up-To-Date And Retrieving Information 336(14)
Keeping up-to-date 336(3)
Retrieving useful information from the Internet 339(3)
General neurology websites 342(1)
Country-based neurology websites 343(1)
Websites related to the more common neurological problems 343(2)
Major neurology journal websites 345(1)
Resources for patients 346(4)
APPENDICES 350(30)
A The Mini-Mental State Examination 351(2)
B Benign focal seizures of childhood 353(2)
C Currently recommended drugs for epilepsy 355(5)
D Treatment of migraine 360(2)
E Epidemiology and primary prevention of stroke 362(7)
F Current criteria for t-PA in patients with ischaemic stroke 369(1)
G Barwon Health Dysphagia Screen 370(3)
H Nerve conduction studies and electromyography 373(5)
I Diagnostic criteria for multiple sclerosis 378(2)
Glossary 380(3)
Index 383
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