Physical diagnosis of pain:an atlas of signs and symptoms

　　1 ORGANIZATION OFTHE NERVOUS SYSTEM 1
　　 Introduction 2
　　 Overview of brain anatomy 2
　　 Internal anatomy of the brain 5
　　 Ventricular system 10
　　 Forebrain 11
　　 Hemisphere specialization 12
　　 Limbic system 14
　　 Orbitofrontal cortex 17
　　 Basal ganglia 17
　　 Diencephalon 17
　　 Thalamus 18
　　 Hypothalamus 19
　　 Peripheral nervous system 21
　　 Putting it all together: from anatomy to behaviour 29
　　2 ELEMENTS OF CELLULAR AND MOLECULAR NEUROSCIENCE 31
　　 Introduction 32
　　 Neurones 32
　　 Glial cells 34
　　 Neurone excitability 35
　　 Neurotransmitters 41
　　 Postsynaptic events and postsynaptic receptors 42
　　3 CLINICAL EXAMINATION 47
　　 Introduction 48
　　 Parts of the clinical examination 48
　　 Other investigations 55
　　 General comments 57
　　4 THE SPINAL CORD 59
　　 Introduction 60
　　 Gross anatomy of the spinal cord and vertebral
　　 column 60
　　 Functional organization of the spinal cord 61
　　 Spinal cord cell types 63
　　 Receptive fields 64
　　 Somatosensory pathways 65
　　 Blood supply to the spinal cord 71
　　 Damage to the spinal cord 72
　　 Comments on the case history 78
　　5 PAIN AND ANALGESIA 79
　　 Introduction 80
　　 Nociceptors 81
　　 Pain pathways 82
　　 How does the central nervous system interpret a
　　 stimulus as painful? 84
　　 Physiology of pain modulation 86
　　 Pain mechanisms after tissue damage: peripheral and
　　 central sensitization 90
　　 Neuropathic pain mechanisms 92
　　 Pharmacology of pain 93
　　 Other approaches to pain management 99
　　 General comments on pain management 104
　　6 CRANIAL NERVES AND THE BRAINSTEM 105
　　 Introduction 106
　　 Anatomical organization of cranial nerves in the brain 106
　　 Internal organization of the brainstem 107
　　 Reticular formation 109
　　 Blood supply to the brainstem ~12
　　 Brainstem reflexes 112
　　 Brainstem lesions 116
　　 Comments on the case history 118
　　7 THE VISUAL SYSTEM 121
　　 Introduction 122
　　 Structure of the eye 122
　　 Visual pathways 125
　　 Visual field defects 127
　　 Pupillary light reflexes 127
　　 Focusing of light on the retina 127
　　 Control of eye movements 130
　　 Structure and function of the retina 131
　　 Processing of visual information 137
　　 Summary 140
　　8 HEARING AND BALANCE: THE AUDITORY AND VESTIBULAR SYSTEMS 141
　　 Introduction 142
　　 The auditory system 142
　　 The vestibular system 152
　　 Comments on the case history 158
　　9 MOTOR SYSTEMS h DESCENDING PATHWAYS AND CEREBELLUM 159
　　 Introduction 160
　　 Skeletal muscle contraction 161
　　 Reflexes 164
　　 Descending pathways 167
　　 Clinical importance of reflexes 172
　　 The cerebellum 175
　　10 MOTOR SYSTEMS II: THE BASAL GANGLIA 181
　　 Introduction 182
　　 The basal ganglia: structure and organization 182
　　 Parkinson's disease 184
　　 Huntington's disease 194
　　11 STROKE AND HEAD iNJURY 199
　　 Introduction 200
　　 Physiological control of cdrebral blood flow 200
　　 Blood supply to the brain 201
　　 Venous system 204
　　 Functional anatomy of the cerebral vasculature 205
　　 Angiography 206
　　 Stroke 206
　　 Head injury 219
　　 Comments on the case history 225
　　12 INFECTION IN THE CENTRAL NERVOUS SYSTEM 227
　　 Introduction 228
　　 Types of infection of the central nervous system 228
　　 The meninges 229
　　 Cerebrospinal fluid production and circulation 230
　　 The blood-brain barrier 232
　　 Meningitis 232
　　 Diagnosis and treatment of meningitis 234
　　 Treatment of meningitis 235
　　 Encephalitis 235
　　 Cerebral abscesses 235
　　 Brain infections in the immunocompromised patient 236
　　13 EPILEPSY 237
　　 Introduction 238
　　 General description of epilepsy 238
　　 Epidemiology of epilepsy 238
　　 Types o.f epileptic syndrome 239
　　 Diagnostic investigations of epilepsy 239
　　 Different types of seizure 242
　　 Neurobiology of epilepsy 243
　　 Pharmacological treatment of epilepsy 246
　　 Other treatments for epilepsy 248
　　 Treatment of status epilepticus 249
　　 Social consequences of epilepsy 249
　　14 DEMENTIA 251
　　 Introduction 252
　　 Causes and diagnosis of dementia 252
　　 Neurobiology of learning and memory 253
　　 Alzheimer's disease 256
　　 Treatment of Alzheimer's disease 261
　　 Other types of dementia 263
　　 General considerations in the management of
　　 Alzheimer's disease and other types of dementia 265
　　15 SCHIZOPHRENIA 267
　　 Introduction 268
　　 Schizophrenia: the clinical diagnosis 268
　　 Aetiology of schizophrenia 271
　　 Neurobiology of schizophrenia 272
　　 Treatment of schizophrenia 275
　　 Comments on the management of schizophrenia and the long-term prognosis 278
　　 Other psychoses and schizophrenia-like syndromes 279
　　16 DEPRESSION AND ANXIETY 281
　　 Introduction 282
　　 Classification o~ mood disorders 282
　　 Clinical features of mood disorders 282
　　 Epidemiology of depression and natural evolution of the disease 283
　　 Genetics of mood disorders 283
　　 Neurobiology of depression 286
　　 Treatment of depression 287
　　 Bipolar disorder and its treatment 292
　　 General comments on mood disorders 293
　　 Need for new therapeutic targets 294
　　 Comments on the case history 294
　　 Anxiety disorders 294
　　 Treatment of anxiety disorders 295
　　 Insomnia 297
　　17 ADDICTION 301
　　 Introduction 302
　　 Addiction and drug misuse: general comments 302
　　 Opiates 302
　　 Cocaine and crack 304
　　 Cannabis 305
　　 Nicotine 307
　　 Alcohol 308
　　 Phencyclidine 309
　　 Amphetamines 310
　　 Ecstasy--or the beginning of agony? 310
　　 Hallucinogens 311
　　 Solvents 311
　　 Neurobiology of addiction 312
　　 Addiction and rehabilitation: general issues 313
　　Index 315