Clinical Neurology

by Marsden, C. David; Fowler, Timothy J.

• ISBN13: 9780340646113
• ISBN10: 034064611X
• Edition: 2nd
• Format: Paperback
• Copyright: 1998-06-25
• Publisher: Hodder Education Publishers

Summary

The second edition of this concise handbook has been produced to help junior doctors, those preparing for the MRCP examination and practising physicians to have a better understanding of the principles of neurology. The basic aims of history-taking, careful neurological examination andassessment of the probable anatomic site or sites of the lesion remain the core of this work which has been expanded to include new sections on neuro-imaging, AIDS and rehabilitation.As in the first edition, emphasis has been given to common neurological disorders presented in a clear and accessible manner. The chapters on ataxias, peripheral neuropathies and muscle diseases have been updated to include new classifications and the identification of some disorders by DNA testing.Material has also been added to take acccount of the latest advances in therapy and of the recent developments in genetics of some neurological disorders.

Table of Contents

Contributors	viii	(2)
Preface to the second edition	x	(4)
Acknowledgements	xi
1 INTRODUCTION	2	(17)
Epidemiology	2	(1)
Anatomical diagnosis	3	(6)
Pathological diagnosis	9	(1)
Special investigations	10	(1)
Electrodiagnostic tests	10	(5)
Cerebrospinal fluid	15	(3)
References and further reading	18	(1)
2 NEUROIMAGING	19	(18)
Introduction	19	(1)
Plain X-rays	19	(1)
CT and MRI	20	(9)
Angiography	29	(4)
Myelography	33	(1)
Doppler sonography	34	(1)
Interventional neuroradiology	35	(1)
Conclusions	36	(1)
References and further reading	36	(1)
3 SYMPTOMS OF NEUROLOGICAL DISEASE	37	(25)
Headache	37	(4)
Pain in the face	41	(1)
Blackouts, fits and faints	42	(4)
Loss of vision	46	(2)
Giddiness	48	(2)
Pain in the arm	50	(2)
Pain in the leg	52	(2)
Difficulty walking	54	(4)
Movement disorders	58	(1)
Decline of memory, intellect and behaviour	59	(2)
References and further reading	61	(1)
4 EXAMINATION OF THE NERVOUS SYSTEM	62	(43)
Neurological examination	62	(12)
Specific abnormalities	74	(30)
References and further reading	104	(1)
5 DISEASES OF MUSCLE AND THE NEUROMUSCULAR JUNCTION	105	(21)
Introduction	105	(1)
Clinical examination	106	(2)
Investigations	108	(2)
Duchenne and Becker muscular dystrophy	110	(2)
Facioscapulohumeral dystrophy	112	(1)
Limb girdle dystrophies	112	(1)
Emery-Dreifuss muscular dystrophy	112	(1)
Oculopharyngeal muscular dystrophy	113	(1)
The glycogen storage diseases	113	(1)
Defects of fatty acid metabolism	114	(1)
Mitochondrial myopathies	114	(1)
The myotonias	115	(4)
Malignant hyperthermia	119	(1)
The congenital myopathies	119	(2)
The inflammatory myopathies	121	(2)
Defects of the neuromuscular junction	123	(2)
References and further reading	125	(1)
6 PERIPHERAL NEUROPATHIES	126	(18)
Pathogenesis	126	(1)
Symptoms and signs	126	(1)
Investigations	127	(2)
Inflammatory demyelinating neuropathies	129	(3)
Diabetic neuropathies	132	(1)
Toxic neuropathies	133	(1)
Uraemic neuropathy	133	(1)
Critical illness neuropathy	134	(1)
Porphyria	134	(1)
Vitamin B(12) deficiency	134	(1)
Vitamin E deficiency	135	(1)
Infective causes	135	(2)
Malignancy	137	(1)
Disorders of protein metabolism	138	(1)
Connective tissue disorders and other vasculitides	139	(1)
Inherited neuropathies	140	(3)
References and further reading	143	(1)
7 NERVE AND ROOT LESIONS	144	(14)
Pressure palsies	144	(1)
Carpal tunnel syndrome	145	(1)
Ulnar nerve lesions	146	(1)
Lateral cutaneous nerve of the thigh	147	(1)
Lateral popliteal nerve	147	(2)
Less common lesions	149	(1)
Brachial plexus lesions	149	(3)
Cervical root problems	152	(2)
Lumbosacral plexus	154	(1)
Lumbar root lesions	154	(2)
References and further reading	156	(2)
8 CRANIAL NERVE SYNDROMES	158	(14)
Cranial nerve I	158	(1)
Cranial nerve II	158	(3)
Cranial nerves III, IV and VI	161	(3)
Cranial nerve V	164	(1)
Cranial nerve VII	165	(2)
Cranial nerve VIII	167	(2)
Cranial nerves IX, X, XI and XII	169	(1)
References and further reading	170	(2)
9 SPINAL DISEASES	172	(14)
Anatomical and pathological considerations	172	(1)
Symptoms and signs of spinal disease	172	(2)
Investigations	174	(1)
Principles of surgical treatment	175	(2)
Common causes of compression of the contents of the vertebral canal	177	(4)
Consideration of disease by spinal section	181	(4)
References and further reading	185	(1)
10 MOVEMENT DISORDERS	186	(19)
Akinetic-rigid syndromes	186	(9)
The dyskinesias	195	(8)
Drug-induced movement disorders	203	(1)
References and further reading	204	(1)
11 CEREBELLAR ATAXIAS AND HEREDITARY SPASTIC PARAPLEGIAS	205	(14)
Cerebellar disorders	205	(1)
Congenital ataxias	205	(1)
Early onset hereditary ataxias	206	(3)
Early onset metabolic ataxias	209	(1)
DNA repair defects	210	(1)
Periodic ataxia	210	(1)
Late onset hereditary cereballar ataxias	210	(2)
Idiopathic degenerative cereballar ataxia	212	(1)
The Ramsay Hunt syndrome (progressive myoclonic ataxia)	213	(1)
Dentatorubropallidoluysian atrophy (DRPLA)	214	(1)
Miscellaneous cerebellar syndromes	214	(2)
The hereditary spastic paraplegias	216	(2)
References and further reading	218	(1)
12 MOTOR NEURONE DISEASE AND SPINAL MUSCULAR ATROPHIES	219	(6)
Motor neurone disease	219	(3)
Spinal muscular atrophies	222	(2)
References and further reading	224	(1)
13 DEMENTIA	225	(19)
Introduction	225	(7)
Types of dementia	232	(10)
Management of dementia	242	(1)
References and further reading	243	(1)
14 EPILEPSY AND SLEEP DISORDERS	244	(20)
Epilepsy -- introduction	244	(13)
Status epilepticus	257	(2)
Sleep disorders	259	(3)
References and further reading	262	(2)
15 MIGRAINE	264	(8)
Migraine with aura (classical migraine)	264	(1)
Migraine without aura (common migraine)	264	(1)
Migraine variants	265	(1)
Migraine equivalents	266	(1)
Childhood migraine	266	(1)
Tension-type headache	266	(1)
Causes of migraine	267	(3)
Prevention of migraine	270	(1)
References and further reading	271	(1)
16 HEAD INJURY	272	(11)
Pathophysiology of head trauma	272	(4)
Medical management of the head injured patient	276	(2)
Management of specific complications of head injury	278	(4)
Outcome	282	(1)
References and further reading	282	(1)
17 RAISED INTRACRANIAL PRESSURE	283	(22)
Symptoms and signs	283	(1)
Shifts and herniations	284	(2)
Hydrocephalus	286	(1)
Benign intracranial hypertension	287	(2)
Intracranial tumours	289	(6)
Posterior fossa tumours	295	(2)
Cerebellopontine angle tumours	297	(4)
Intracranial abscess	301	(2)
Parasitic cysts	303	(1)
References and further reading	304	(1)
18 INFECTIONS OF THE CENTRAL NERVOUS SYSTEM	305	(19)
Meningitis	305	(9)
Encephalitis	314	(2)
Cerebral malaria	316	(1)
CNS infection in the immunocompromised patient	317	(1)
Poliomyelitis	318	(1)
Tetanus	319	(1)
Lyme disease	320	(1)
Syphilis	321	(1)
References and further reading	322	(2)
19 HIV INFECTIONS AND AIDS	324	(9)
Opportunistic infections	324	(3)
Lymphoma	327	(1)
Conditions unrelated to opportunistic infection	328	(2)
Paediatric AIDS	330	(1)
Cerebrovascular disease	330	(1)
Summary	330	(1)
References and further reading	331	(2)
20 DEMYELINATING DISEASES OF THE CENTRAL NERVOUS SYSTEM	333	(9)
Introduction	333	(1)
Multiple sclerosis	333	(5)
Acute disseminated encephelomyelitis	338	(1)
Devic's neuromyelitis optica	339	(1)
Central pontine myelinolysis	339	(1)
Progressive multifocal leukoencephalopathy	340	(1)
Leukodystrophies	340	(1)
Phenylketonuria	341	(1)
References and further reading	341	(1)
21 PAEDIATRIC NEUROLOGY	342	(19)
Disorders of CNS development	342	(8)
Cerebral palsy	350	(1)
Learning disability	351	(4)
Neurometabolic disorders	355	(5)
References and further reading	360	(1)
22 CEREBROVASCULAR DISEASE	361	(19)
Ischaemic stroke	361	(2)
TIAs	363	(6)
Cerebral haemorrhage	369	(3)
Subarachnoid haemorrhage	372	(2)
Unusual causes of stroke	374	(4)
Prognosis and rehabilitation	378	(1)
References and further reading	379	(1)
23 NEUROLOGICAL COMPLICATIONS OF MEDICAL DISORDERS	380	(19)
The pituitary gland	380	(2)
Thyroid disorders	382	(1)
Adrenal disturbance	383	(1)
Hypoglycaemia	383	(1)
Hyperglycaemia	384	(1)
Hepatic failure	384	(1)
Reye's syndrome	385	(1)
Renal failure	385	(1)
Electrolyte disturbances	386	(1)
Calcium metabolism	387	(1)
Vitamin deficiencies	387	(2)
Toxic effects	389	(3)
Physical insults	392	(2)
Connective tissue diseases	394	(1)
Remote effects of cancer on the nervous system	395	(1)
Behcet's disease	396	(1)
Sarcoidosis	397	(1)
References and further reading	397	(2)
24 PSYCHIATRIC DISORDERS	399	(20)
Psychiatric diagnosis	399	(1)
Neuroses	400	(5)
Neuroses and psychoses	405	(1)
The psychoses	406	(1)
Schizophrenia	407	(1)
Affective disorders	408	(4)
Organic psychoses	412	(1)
Some other psychiatric disorders	413	(2)
The Mental Health Act (1983)	415	(1)
References and further reading	416	(3)
25 NEUROREHABILITATION	419	(6)
The size of the problem	419	(1)
Aim	419	(1)
Assessment	419	(2)
Rehabilitation process	421	(1)
Aids and appliances	421	(1)
Measuring outcome	422	(1)
Rehabilitation: where should it be done?	422	(1)
References and further reading	423	(2)
APPENDICES	425	(5)
Proprietary drug names	425	(1)
Recognized genetic defects in some selected neurological disorders	426	(4)
Index	430