Introduction to clinical neurology

Question 1

Incidence in GP

ie what’s referred to in hospitals

Answer 1

Stroke
Carpal Tunnel Syndrome
Epilepsy
Bells Palsy
Tremor
Parkinson's Disease
Brain Tumour
Multiple Sclerosis

Question 2

Prevalence in community

Answer 2

Migraine
Stroke
Alzheimer's Disease
Epilepsy
Tremor
Multiple Sclerosis
Chronic Fatigue Syndrome
Parkinson's Disease

Question 3

Structured approach of neurological practise

Answer 3

Localization (Where is it?)
▪ Muscle
▪ Neuromuscular Junction (NMJ)
▪ Peripheral Nerve
▪ Spinal Cord
▪ Brain

What sort of problem could it be (as you down, increase speed of onset
•  Traumatic 
•  Vascular 
•  Toxic/Metabolic 
•  Infectious 
•  Inflammatory/Autoimmune 
•  Genetic-congenital 
•  Neoplastic
•  Degenerative

Question 4

Approach to a diagnosis

Answer 4

1. Clinical Facts – History and examination.
2. Interpretation in terms of physiology/anatomy.
3. Syndromic formulation and lesion localization.
4. Anatomic diagnosis and mode of onset.
5. Use investigation to confirm/refute clinical judgment.

Question 5

Main components of standard neurological examination

Answer 5

Cognitive examination – Mini Mental State Examination.
Cranial Nerves – Smell, vision, eye movements, facial sensation and movements.
Limbs – Power, coordination, reflexes and sensation.

Question 6

Key diagnostic techniques used in neurological diagnosis

Answer 6

▪ Brain Scans:
CT.
MRI.
▪ Cerebrospinal Fluid (CSF):
Lumbar Puncture.
▪ Nerve Conduction Studies and Electromyography (EMG).
▪ Electroencephalogram (EEG) and Evoked Potentials.
▪ Brain Pathology:
Damage to cells or larger structure.