By Andrew Tarulli
This concise, completely up to date textual content presents a accomplished, state-of-the paintings evaluation of neurology and may function a hugely functional source for neurology citizens and scientific scholars. Emphasizing a realistic method of universal neurologic problems, the writer blends chapters that disguise the evaluate of particular lawsuits (confusion, dizziness and vertigo, visible loss, headache and facial ache) with others that target specific issues (Parkinsonism, a number of sclerosis, dementia). Noting the center perform of neurology is basically unchanged from years in the past and nonetheless mostly performed on the bedside, the writer emphasizes the significance of buying services within the time-tested, classical innovations of historical past taking, directed exam, and localization. towards that, the writer encourages a spotlight at the key medical pathways for prognosis and administration. a variety of medical pearls are supplied and the diagrams and illustrations are well-designed and understandable, as are the medical photographs (EEGs, CT, MRI) which offer first-class examples of numerous neurologic problems. The discussions and algorithms provided are evidence-based and state of the art. Importantly, the writer discusses a number new, robust remedies to be had for varied issues, together with stroke, epilepsy, and a number of sclerosis. Concise and well-written, Neurology: A Clinician’s method, 2nd Edition is a useful source that may back function a truly important, gold-standard source for trainees.
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Extra resources for Neurology: A Clinician’s Approach
In many cases the history contains few details beyond the patient being “found down” and the evaluation of the comatose patient quickly shifts to physical examination and diagnostic testing. Examination Mental Status Examination The purpose of the mental status examination of the comatose patient is to verify that they are actually comatose rather than merely encephalopathic. Before beginning the examination, make sure to discontinue any short-acting sedatives such as midazolam or propofol. By definition, a comatose patient’s eyes should be closed and they should appear as if they are sleeping.
Articulatory errors are apparent word substitutions produced by patients with dysarthria. These are not technically paraphasias, but in some cases may resemble phonemic errors. Neologisms are new words formed from appropriate phonemes which do not resemble an identifiable target word. These are particularly characteristic of posterior aphasias such as Wernicke aphasia. Comprehension While it is generally true that nonfluent aphasics comprehend spoken language better than fluent aphasics do, all aphasic patients have some degree of comprehension impairment.
Cold water placed in the right ear produces no response; cold water placed in the left ear produces tonic ipsilateral eye deviation (Fig. 5b). This is the pattern seen in patients with right vestibular nerve or lateral pontine damage. 3. Cold water placed in the right ear produces rightward eye deviation of the right eye only; cold water placed in the left ear produces leftward eye deviation of the left eye only (Fig. 5c). This is consistent with a midline lesion of the midbrain and pons producing bilateral internuclear ophthalmoplegia (Chap.