دانلود کتاب The Neurologic Examination: Scientific Basis for Clinical Diagnosis [Team-IRA]

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Cover
The Neurologic Examination
Copyright
In Memoriam
Dedication
Contents
List of Boxes
Preface to the First Edition
Preface to the Second Edition
Explanatory Notes
Acknowledgments
1. Diagnosis of neurological diseases
1. Axis 1: anatomic diagnosis
A. Distribution of the lesion at the tissue level
B. Selective vulnerability
C. Negative versus positive neurological symptoms and signs
2. Axis 2: etiologic diagnosis
3. Axis 3: clinical diagnosis
Bibliography
2. History taking
1. The present age and the age at onset
2. Sex
3. Handedness
4. Chief Complaints
5. History of the present illness
6. Past medical history
7. Social History
8. Family history
Bibliography
3. Physical examination
1. General physical examination and neurologic examination
A. General Physical Examination at the Initial Clinical Evaluation
B. Skin abnormalities seen in congenital or hereditary neurological diseases
C. Skin abnormalities seen in inflammatory neurologic diseases
D. Skin abnormalities seen in toxic neurologic diseases
E. Sunlight photosensitivity of skin
F. Abnormalities of oral cavity seen in neurologic diseases
G. General physical findings and neurological findings
2. Neurological manifestation of systemic medical diseases
A. Collagen vascular diseases
B. Endocrine diseases
C. Metabolic diseases and syndromes
D. Hematologic diseases
E. Behçet disease
F. Sarcoidosis
G. Neoplasm
3. Steps of the neurologic examination
Bibliography
4. Evaluation of consciousness
1. Anatomic basis of consciousness
2. Mechanisms of disturbances of consciousness
3. Observation of the state of consciousness
4. Modes of consciousness disturbance and the coma scale
5. Conditions that should be distinguished from clouding of consciousness
A. Deep Sleep
B. Advanced stage of dementia
C. Akinetic mutism
D. Locked-​in syndrome
Bibliography
5. Brainstem and cranial nerve territories
1. Brainstem
2. Common structures of cranial nerves
3. Cranial nerves related to the motor function
4. Cranial nerves related to somatosensory function
5. Cranial nerves related to autonomic nervous function
6. Location of the cranial nerve nuclei in brainstem
7. Neurologic examination of the cranial nerve territory
Bibliography
6. Olfactory sensation
1. Structures and neurotransmitters of the olfactory system
2. Examination of olfactory sensation
Bibliography
7. Visual functions
1. Anatomy and function of the visual system
A. Retina
B. Fovea centralis and optic disc
C. Blood supply to the retina
D. Optic nerve and optic chiasm
E. Lateral geniculate body and optic radiation
F. Visual cortex
G. Blood supply to the visual pathway
H. Cytoarchitecture of the visual system and higher cortical functions
I. Special visual functions
2. Examination of visual functions
A. Visual acuity
B. Visual fields
i. Central scotoma
ii. Other visual field defects
iii. Constriction of peripheral visual field
C. Ophthalmoscopic examination of ocular fundus
i. Optic disc
ii. Physiologic cup of optic disc
iii. Fovea centralis
iv. Retinal pigment degeneration
v. Observation of retinal blood vessels
Bibliography
8. Pupils and accommodation
1. Nerve innervation of intraocular muscles
A. Light reflex and convergence reflex
B. Sympathetic nervous system and Horner syndrome
C. Accommodation and its abnormality
2. Examination of intraocular muscles
A. Oculomotor nerve palsy and Horner syndrome
B. Examination of the light reflex and its abnormality
C. Special abnormal findings of pupils
D. Examination of the convergence reflex
E. Examination of accommodation
Bibliography
9. Extraocular muscles, gaze, and eye movements
1. Nerve innervation of extraocular muscles
A. Third cranial nerve (oculomotor nerve)
i. Intramedullary lesion of the oculomotor nerve and crossed hemiplegia
ii. Extramedullary lesion of the oculomotor nerve
iii. Cavernous sinus syndrome
B. Fourth cranial nerve (trochlear nerve)
C. Sixth cranial nerve (abducens nerve)
2. Neural control mechanism of gaze
A. Central control mechanism of gaze
B. Lateral gaze and lateral gaze palsy
C. Vertical gaze and vertical gaze palsy
D. Convergence and convergence palsy
3. MLF and internuclear ophthalmoplegia
4. Central control mechanism of eye movements
A. Central control mechanism of saccades
B. Central control mechanism of smooth pursuit
C. Roles of cerebellum and basal ganglia in eye movements
5. Examination of extraocular muscles and gaze
A. Ptosis
i. Bilateral ptosis
ii. Unilateral ptosis
iii. Blepharospasm
B. Examination of extraocular muscles
i. Vertical paralysis of one eye
ii. Congenital disorders of extraocular muscles
iii. Causes of diplopia or extraocular muscle paralysis
iv. Ocular myopathy
C. Examination of fixation and gaze
i. Lateral gaze palsy and conjugate deviation of eyes
ii. Oculogyric crisis
iii. Gaze paralysis and ocular motor apraxia
iv. Eye- tracking test
v. Optokinetic nystagmus
6. Involuntary movements of eyes
A. Spontaneous nystagmus
B. Gaze nystagmus
C. Ocular myoclonus
D. Opsoclonus
E. Ocular bobbing and ocular dipping
7. Comprehensive examination of eye movements
Bibliography
10. Trigeminal nerve
1. Structures and functions
A. Somatosensory pathway
B. Cortical reception of somatosensory input from face
C. Nerve innervation of masticatory muscles
D. Reflex pathway of jaw jerk
E. Neural pathway of corneal reflex
2. Examination of functions related to the trigeminal nerve
A. Motor nerve
i. Trismus (lockjaw)
ii. Jaw-​winking phenomenon
B. Sensory nerve
C. Jaw jerk (masseter reflex)
D. Corneal reflex
E. Primitive reflexes
Bibliography
11. Facial nerve
1. Structures and functions
A. Motor nerve
B. Somatosensory nerve
C. Taste sense
D. Lacrimation and salivation
E. Parasympathetic innervation of facial skin and mucosa
2. Examination of functions related to the facial nerve
A. Motor function
i. Central facial paralysis and peripheral facial paralysis
ii. Crossed hemiplegia of facial muscle
iii. Mimetic muscles
B. Somatosensory function
C. Gustatory sense
D. Lacrimation and salivation
E. Facial skin and mucosa
Bibliography
12. Auditory function
1. Structures of the auditory pathway
A. Brainstem auditory evoked potentials
B. Cognitive functions related to the auditory sense
2. Examination of auditory function
A. Tinnitus
B. Sensorineural deafness
Bibliography
13. Sense of equilibrium
1. Structures and functions of the pathways related to equilibrium
2. Examination of the sense of equilibrium
A. Vestibular nystagmus
B. The vestibulo-​ocular reflex
C. Caloric test
Bibliography
14. Swallowing, phonation, and articulation
1. Innervation of swallowing, phonation, and articulation
A. Glossopharyngeal nerve and vagus nerve
B. Hypoglossal nerve
C. Cortical innervation of bulbar muscles
D. Involvement of the cranial nerves innervating bulbar muscles
2. Somatosensory innervation of pharynx and larynx
3. Taste sense
4. Salivation
5. Autonomic innervation of visceral organs
6. Afferent pathway from the visceral organs
7. Examination of swallowing, phonation, and articulation
A. Examination of the tongue
B. Examination of the soft palate
C. Spasm of the deglutition muscles
D. Dysphonia
E. Dysarthria
F. Bulbar palsy and pseudobulbar palsy
Bibliography
15. Neck and trunk
1. Examination of the neck
A. Postural abnormality of the neck
B. Examination of muscles innervated by the accessory nerve
C. Cervical spondylosis
D. Lhermitte sign
E. Meningeal irritation
2. Examination of the trunk
Bibliography
16. Motor functions and movement disorders
1. Final common pathway of the motor system
A. Motor cortex and corticospinal tracts
i. Pyramidal tract and upper motor neuron
ii. Corticospinal tract
iii. Lesion of the corticospinal tract and distribution of motor paralysis
B. Structure and function of spinal cord
i. Laminar structure of the lateral corticospinal tract
ii. Blood perfusion of the spinal cord
C. Anterior horn cells and peripheral motor nerves
i. α motor fibers
ii. Motor unit and reinnervation
iii. γ motor fibers
D. Neuromuscular junction and muscle
2. Central control of voluntary movement
A. Higher functions of motor cortices
B. Basal ganglia
i. Cytoarchitecture of striatum and neural circuits of basal ganglia
ii. Nigrostriatal system
iii. Deep brain stimulation in Parkinson disease
iv. Significance of raphe nucleus and locus coeruleus
v. Parkinsonism
vi. Causes of parkinsonism
vii. Disability rating score of Parkinson
C. Cerebellum
i. Cytoarchitecture of cerebellum
ii. Cerebellar circuit and clinical
iii. Spinocerebellar degeneration
iv. Acquired cerebellar ataxia
v. Tumors of the cerebellum
Bibliography
17. Examination of Motor Functions
1. Posture
2. Muscle atrophy and fasciculation
A. Muscle atrophy
B. Fasciculation
C. Muscle hypertrophy
3. Muscle strength
A. Manual muscle testing
B. Muscle pain
C. Sites of lesion for monoplegia
D. Root lesions
E. Plexus lesions
F. Acute polyneuritis
G. Atypical acute polyneuritis
H. Chronic inflammatory demyelinating polyneuropathy
I. Toxic polyneuropathy
J. Metabolic polyneuropathy
K. Hereditary polyneuropathy
L. Spastic paralysis
M. Gowers sign
N. Disuse atrophy
4. Muscle tone
A. Spasticity
B. Clonus
C. Rigidity
D. Hypotonia
5. Muscle spasm and cramp
A. Hemifacial spasm
B. Tetanus
C. Stiff-​person syndrome and progressive encephalomyelitis with rigidity and myoclonus
6. Myotonia
7. Coordination
Bibliography
18. Tendon reflexes and pathologic reflexes
1. Physiologic mechanism of the tendon reflex
2. Examination of tendon reflexes
A. Tendon reflex of the distal extremity muscles
B. How to confirm loss of ankle jerk
C. Significance of hyperactive tendon reflexes
3. Pathologic reflexes and their generating mechanisms
4. Loss of superficial reflex as a pyramidal sign
A. Abdominal reflex (abdominal wall reflex)
B. Cremasteric reflex
Bibliography
19. Involuntary movements
1. Examination of involuntary movements
2. Tremor
A. Resting tremor
B. Postural tremor
i. Essential tremor
ii. Other conditions presenting with postural tremor
iii. Titubation
iv. Physiologic tremor
C. Action tremor
3. Chorea
4. Ballism
5. Athetosis
6. Dystonia
A. Functional abnormality of the sensori-​motor cortex in focal dystonia
B. Fixed dystonia
C. Sensory trick
D. Causes of generalized dystonia
E. Hereditary dystonia
7. Dyskinesia
8. Myoclonus
A. Myoclonus of cortical origin
i. Cortical reflex myoclonus
ii. Causes of cortical myoclonus
iii. Negative myoclonus
B. Myoclonus of brainstem origin
C. Myoclonus of spinal cord origin
D. Myoclonus of undetermined origin
i. Creutzfeldt–​Jakob disease
ii. Subacute sclerosing panencephalitis (SSPE)
9. Motor stereotypies
10. Involuntary movements that can be suppressed momentarily
A. Tics
B. Functional (psychogenic) involuntary movements
C. Restless legs syndrome
11. Involuntary movements of peripheral nerve origin
Bibliography
20. Somatosensory function
1. Structure and functions of the somatosensory system
A. Somatosensory receptors
B. Peripheral somatosensory nerves
C. Somatosensory pathway in the spinal cord
D. Nociceptive pathway
E. Proprioceptive pathway
F. The third sensory neuron and cortical receptive areas
2. Examination of somatosensory function and abnormal findings
A. Examination of somatosensory function
B. Somatosensory symptoms and signs
C. Impairment of the somatosensory nervous system and distribution of the sensory symptoms
i. Polyneuropathy primarily presenting with sensory symptoms
ii. Segmental sensory impairment
iii. Sensory impairment in a transverse
iv. Brown– Séquard syndrome
Bibliography
21. Autonomic nervous system
1. Structure and function of the autonomic efferent system
A. Sympathetic nervous system
B. Parasympathetic nervous system
C. Disorders of the peripheral autonomic nerves
D. Cortical center of the autonomic nervous system
E. Neural control of urination
2. Structure and function of the autonomic afferent system
3. Examination of the autonomic nervous function
A. Autonomic symptoms of skin
B. Micturition and sexual functions
C. Gastrointestinal symptoms
D. Orthostatic hypotension
Bibliography
22. Posture and gait
1. Central control mechanism of gait
2. Examination of gait
A. Freezing of gait
B. Ataxic gait
C. Waddling gait and steppage gait
Bibliography
23. Mental and cognitive functions
1. Examination of mental and cognitive functions
A. Orientation
B. Memory
i. Examination of memory
ii. Korsakov (Korsakoff) syndrome
C. Calculation
D. Common knowledge and judgment
E. Emotion and character
F. Illusion, hallucination, and delusion
G. State of daily living
2. Dementia
A. Alzheimer disease and related disorders
i. Alzheimer disease
ii. Lewy body dementia and Parkinson
iii. Basal ganglia and cognitive functions
B. Frontotemporal lobar degeneration
C. Leukoencephalopathy
Bibliography
24. Aphasia, apraxia, and agnosia
1. Neural circuits related to language, praxis, and recognition
A. Focal neurological deficit and disconnection syndrome
B. Language
C. Classification of aphasia
D. Spoken language and written language
E. Praxis
F. Classification of apraxia
G. Task-​specific apraxia
H. Mirror neuron
I. Recognition
J. Disturbance of auditory recognition
K. Higher visual functions and their disturbance 237
L. Visuospatial agnosia
M. Positive symptoms of higher visual functions
2. Examination of language, praxis, and recognition
A. Examination of language
i. Motor aphasia
ii. Sensory aphasia
iii. Conduction aphasia
B. Examination of praxis
C. Examination of recognition
i. Visual recognition
ii. Hemispatial neglect
D. Use of a simple test battery
Bibliography
25. Epilepsy and convulsion
1. Classification of epileptic seizures
A. Focal epileptic seizures
B. Generalized epileptic seizures
2. Diagnosis of epilepsy
A. Evaluation of medically intractable epileptic seizures
B. Psychogenic non- epileptic seizures
Bibliography
26. Headache and migraine
1. Classification of headache
2. Migraine and related disorders
A. Cluster headache
B. Reversible cerebral vasoconstriction syndrome
3. Tension-​type headache
Bibliography
27. Sleep disorders
1. Obstructive sleep apnea–​hypopnea syndrome
2. Central sleep apnea–​hypopnea syndrome
3. REM sleep behavior disorders (RBD)
4. Narcolepsy and related disorders
5. Periodic limb movement in sleep
6. Kleine–​Levin syndrome
7. Fatal familial insomnia
Bibliography
28. Episodic neurological disorders related to ion channels
1. Hereditary channelopathies
A. Hereditary channelopathies of the central nervous system
i. Familial hemiplegic migraine
ii. Episodic ataxia
iii. Hereditary startle disease, hyperekplexia
iv. Epilepsies
B. Hereditary channelopathies of the peripheral nervous system
C. Hereditary channelopathies of muscles
i. Hypokalemic periodic paralysis
ii. Hyperkalemic periodic paralysis
iii. Myotonia congenita
iv. Paramyotonia congenita
v. Andersen–​Tawil syndrome
vi. Malignant hyperthermia susceptibility
vii. Central core disease
viii. Congenital myasthenic syndrome
2. Autoimmune channelopathies
A. Myasthenia gravis
B. Lambert–​Eaton syndrome
C. Isaacs syndrome (neuromyotonia)
Bibliography
29. Functional (psychogenic) neurological diseases
1. Functional motor paralysis
2. Functional sensory loss
3. Constriction of visual field
4. Common features of functional neurological diseases
Bibliography
30. Relay center of all sensory and motor functions (thalamus)
1. General structure of the thalamus
2. Ventral posterior nucleus as the sensory relay center
3. Ventral anterior nucleus and ventrolateral nucleus as the motor thalamus
4. Medial dorsal nucleus as a relay center to the prefrontal cortex
5. Anterior nucleus and memory
6. Pulvinar as a relay center to the parietal lobe
7. Intralaminar nucleus as a relay center of the ascending reticular activating system
8. Relay nucleus for the visual and auditory system
Bibliography
31. Adjustment to the external environment and control of the internal milieu (hypothalamus and neuroendocrinology)
1. Structure and function of the hypothalamus
2. Neuroendocrinology
A. Anterior lobe of the pituitary gland (adenohypophysis)
B. Posterior lobe of the pituitary gland (neurohypophysis)
3. Adjustment to the external environment and control of the internal milieu
A. Control of circadian rhythm
B. Control of feeding
C. Control of body temperature
D. Homeostasis
Bibliography
32. Infectious diseases of the nervous system
1. Bacterial infection of the nervous system
2. Spirochete infection of the nervous system
3. Viral infection of the nervous system
4. Parasitic infection of the nervous system
5. Fungal infection of the nervous system
6. Transmissible form of prion disease
Bibliography
33. Neurological emergency
1. Disorders with respiratory paralysis
A. Crisis of myasthenia gravis
B. Edrophonium (Tensilon) test
C. Guillain–​Barré syndrome
D. Acute anterior poliomyelitis
E. Acute brainstem lesion
F. Amyotrophic lateral sclerosis
2. Disorders with disturbance of consciousness
3. Stroke
4. Status epilepticus
A. Treatment of convulsive status epilepticus
B. Tetanus
5. Conditions expected to have poor functional recovery unless appropriately treated at early clinical stage
A. Acute compression of spinal cord
B. Progressive ischemic cerebrovascular diseases
6. Examination of coma
A. Degree of coma (coma scaling)
B. Presence or absence of asymmetry in neurological signs
C. Examination of brainstem functions
i. Observation of respiration
ii. Brainstem reflexes
D. Cerebral herniation
i. Anisocoria
ii. Decerebrate posture
iii. Tonic neck reflex
iv. False localizing signs
E. Meningeal irritation
7. Judgment of brain death
Bibliography
34. Disability, functional recovery, and prognosis
1. Assessment of disability scale
2. Mode of tissue damage, functional disability, and recovery
A. Gray matter lesion versus white matter lesion
B. Axonal damage versus myelin damage
3. Mechanisms of functional recovery
A. Plastic reorganization
B. Mobilization of reserve functions
Bibliography
35. How to plan laboratory tests
1. Functional neuroimaging studies and electrophysiologic studies
2. Lumbar puncture
3. Genetic tests
4. Use of laboratory tests to prevent disease
Bibliography
Afterword: For those who wish to study neurology
Index