2 Clinical Neurology- An Overview

Question 1

Q: What is neurology?

Answer 1

A: diseases of brain, spinal cord, peripheral nerves and muscle

Question 2

Q: When diagnosing neurological problems, what is involved in the approach? (2)

Answer 2

A: -using the presenting signs and symptoms to identify the underlying anatomy and characterise the syndrome
-use mode of onset and time to determine the most likely aetiology (or pathological cause)

Question 3

Q: When diagnosing neurological problems, what is involved in taking the history? (4)

Answer 3

A: -what has changed?

• what can you no longer do?
• progressive or sudden?
• family history?

Question 4

Q: When diagnosing neurological problems, what is involved in the examination? (3)

Answer 4

A: -cognitive/thinking abilities: mini mental state examination

• cranial nerves- smell, vision, eye movement, facial sensation and movements
• limbs- power, coordination, reflexes, sensation

Question 5

Q: When diagnosing neurological problems, what is involved in the investigations? (5)

Answer 5

A: -brain scans (CT and MRI)

• cerebrospinal fluid (CSF) - lumbar puncture
• nerve conduction studies and electromyography (EMG)
• electroencephalogram (EEG- brain waves) and evoked potentials
• brain pathology - damage to cells or larger structures

Question 6

Q: How can cerebrospinal fluid be a test for neurological problems?

Answer 6

A: -clear is normal

-if yellow/discoloured= sign of injury/infection of brain

Question 7

Q: What is the treatment of Alzheimers often based on?

Answer 7

A: removing plaques in brain

Question 8

Q: In terms of diagnosing neurological problems, describe syndromic formulation. (5)

Answer 8

A: 1. clinical facts- history and examination

2. interpretation in terms of physiology/anatomy
3. syndromic formulation and lesion localisation
4. anatomic diagnosis and mode of onset
5. use investigations to confirm or refute clinical judgement