7.5 X 12 Long Title.P65

Cambridge University Press 978-0-521-72222-3 - Neurology: A Clinician’s Approach Andrew Tarulli Index More information

Index

3,4-diaminopyridine 86 diagnostic testing 33 coma and 19 examination findings28–29 , 32 drug interactions 172–174 abducens nerve lesions 49, 50 symptoms 27, 33, 166 first-time seizure treatment abscess treatment 33 167–169 epidural 140 amantadine 106, 107, 205 inadequate dosing 172 intracranial 210, 212 aminoglycosides 99 neuropathic pain use 125, 157 abulia 27, 35 amiodarone 111, 124 nonconvulsive status epilepticus acetaminophen 18, 138 amitriptyline 125, 154 (NCSE) use 9 acetazolamide 76, 153 ammonia levels 6, 82 polytherapy combination acetylcholine receptor (AChR) amnesia. See memory suggestions 173 antibodies 85, 98 amphiphysin antibodies 116 renal dysfunction and 169 acetylcholinesterase inhibitors ampicillin 6 status epilepticus management cholinergic crisis 99 amyloidosis/amyloid angiopathy 123, 175–176 dementia treatment 33, 34, 35, 107 193 summary of 167, 168 edrophonium test 55 amyotrophic lateral sclerosis (ALS) withdrawal of 175 Lambert–Eaton myasthenic 65, 87–88 anti-CV2/CRMP5 antibodies 9 syndrome (LEMS) treatment 86 creative kinase (CK) levels 81 antidepressant drugs myasthenia gravis treatment 56, 85 delayed diagnosis 78 coma inducement 19 acid maltase deficiency 85 dysarthria 87 pain management 125, 134, 157 acid-fast bacilli (AFB) 9 dysphagia 66–67 Parkinson’s disease 107 acute disseminated encephalomyelitis focal limb weakness 91, 93 antiemetic agents 156 (ADEM) 201 reflex abnormalities 81, 87 anti-Hu (ANNA-1) antibodies 9, 76 acute inflammatory demyelinating anal wink 138 antihypertensive drugs, stroke polyradiculoneuropathy (AIDP). anemia 126 management/prevention 188, See Guillain–Barré syndrome aneurysm 189, 192 acyclovir 7 posterior communicating artery anti-Jo-1 antibodies 83 Adie’s tonic pupil 60 (PCOM) 12, 59, 60 anti-Ma2 antibodies 9 adjustment disorders 127 unruptured intracranial 150–151 anti-MAG (myelin-associated adrenocorticotropic hormone angiography 150, 186, 189 glycoprotein) 123 infusions 113 angle closure glaucoma 46 antimyelin antibodies 200 adrenoleukodystrophy (ALD) anisocoria 59–61 antiphospholipid antibody syndrome 141–142, 202 anomia 24, 25 115 adrenomyeloneuropathy (AMN) 142 anosodiaphoria 3 antiplatelet therapy 190 adult attention deficit hyperactivity anosognosia 3 antipsychotic drugs/neuroleptics disorder (ADHD) 38 anterior cerebral artery (ACA) stroke drug-induced parkinsonism 108, albendazole 213 syndromes 178–179 111 alcohol abuse anterior choroidal artery (AChA) Parkinson’s disease treatment 107 coma and 18 infarction 180 tardive dyskinesia (TD) and 117 confusion 4–6 anterior inferior cerebellar artery anti-Ri antibodies 76 dementia and 36–37 (AICA) 181 anti-Tr antibodies 76 myopathies and 84 anterior spinal artery syndrome 142–143 anti-Yo antibodies 76 polyneuropathy and 124 anticholinergic drugs 107. Anton’s syndrome 47, 181 withdrawal 111, 165, 167 Seealsospecific drugs19 anxiety 111, 127, 205 aldolase 81 anticoagulant therapy aphasia alexia without agraphia 47, 181 reversal of 192 assessment of 22–24 “alien hand” phenomenon 108 stroke management/prevention cause determination and treatment almotriptan 154 187–188, 189, 190, 191, 192 26 Alzheimer’s disease (AD) anticonvulsant drugs. Seealsospecific clinically focused approach to 22 age of onset 28 drugs confusion differentiation2

214

Index

different syndromes24–26. Behcet’s disease 202 brain tumors 208–209, 211–212 Seealsospecific syndromes Bell’s palsy 9, 58–59, 64 intracranial hemorrhage (ICH) dysarthria and 65 mimics of 64 etiology 193 mimics of 22 stroke differentiation 62–64, 184 seizure and 166 primary progressive (PPA) 27, 36 Bell’s phenomenon 62 brainstem catastrophe 99 recovery and rehabilitation 26 benign paroxysmal positional vertigo brainstem lesions 14, 15 stroke 178 (BPPV) 73 breast cancer, brachial plexopathy and aphemia 25 benzodiazepines 128–129 apnea test 20 coma and 18 Broca’s aphasia 24, 178 apneustic breathing 17 ethanol withdrawal use 5 Brudzinski’s sign 6 apraxia nonconvulsive status epilepticus bruits 184, 191 confusion and 2 (NCSE) management 9 dementia-related 27, 29–30 Parkinson’s disease treatment 105 CADASIL (cerebral autosomal examination of 29–30 status epilepticus management 175 dominant arteriopathy with eyelid opening 59 withdrawal from 111 subcortical infarcts and parkinsonism 104, 108 beriberi 100, 203 leukoencephalopathy) 202 arm/hand pain 128, 136 beta agonists 111 caffeine intoxication111 arm/hand weakness 63, 64, 90–92, 182 beta interferon 203, 204 calcineurin inhibitors 10 arsenic poisoning 98, 100 Bickerstaff’s brainstem encephalitis calcium channel blockers 127 arteriovenous malformations (AVM) 55 capsaicin cream 125, 158 142, 166, 193, 202, 210 Binswanger’s disease 35 carbamazepine aspiration 191 biopsy drug interactions 172–174 aspirin 190, 205 muscle 82 hyperkinetic movement disorders asterixis 2, 6 nerve 123 treatment 116, 117 ataxia bladder dysfunction. See incontinence neuropathic pain management 125, breathing 17 bleeding diatheses 193 157 episodic 76 blepharospasm 59 polytherapy combinations 173 gait abnormalities 145, 146 blink reflexes 13–14 renal dysfunction and 169 hemiparesis and 182 blood tests seizure management 167, 168, 171 multiple sclerosis (MS) 198 confusion diagnostic testing 4 carbidopa 105, 106, 107 neuropathies 122 dementia diagnosis 32 carbon monoxide 103 parkinsonism 102 diabetic neuropathy 123 cardiovascular evaluation, stroke 184, spinocerebellar 202 polyneuropathy screening panel 122 188–189 truncal 71 rapidly progressing weakness 98 carotid artery dissection 61, 151, 180 Wernicke’s encephalopathy 5 seizure investigation 163 carotid artery stenosis 189, 190–191 athetosis 114, 117 stroke investigation 184, 189 carotid artery stenting 191 atomoxetine 38 Borrelia antibodies 9 carotid endarterectomy (CEA) 66, atorvastatin 84, 189 botulinum toxin injections 210 ATP (adenosine triphosphate) 81 dysphonia treatment 65 carpal tunnel syndrome (CTS) 95, atrial fibrillation (AF) 188, 190 eyelid disorders 57, 59 131 attention hyperkinetic movement disorders carpometacarpal (CMC) joint assessment of 1–2, 28 treatment 110, 112, 115, 116, arthritis 132 disturbance of. See confusion 117 cataplexy 162 augmentation 126 spasticity treatment 205 catatonia 18 aura 149, 153, 183 botulism cauda equina syndrome 92, 137–138, azathioprine 83, 85, 99, 204 coma mimicry 18 139 dysphagia 67 caudate nuclei atrophy 104, 114 back pain ptosis 57, 59 cavernous sinus lesions 51, 52, 54, neurological 136–140 rapidly progressing weakness 96, 60, 61 non-neurological 140–143 97, 98, 99–100 ceftriaxone6 , 9 baclofen 116, 157, 204 brachial plexopathy 60, 61, 89–90, cerebellar infarction 73, 181, 188 ballismus 113, 162 128–129, 130 cerebellar outflow tremor 112 Balo’s concentric sclerosis 206 bradykinesia cerebellopontine angle (CPA) tumors barbecue spit maneuver 74 Huntington’s disease (HD) 114 75 basilar artery stroke syndromes oropharyngeal 67, 107 cerebral artery infarction 2 180–181 parkinsonism 102, 103, 105, 107 cerebral venous thrombosis 182 Becker’s muscular dystrophy (BMD) treatment 105–106 cerebral venous sinus thrombosis 83, 116 weakness mimicry 78 (CVST) 152 behavioral abnormalities, brain death 13, 16, 17 cerebrospinal fluid analysis. See CSF dementia-related 27, 34 diagnosis of 19–20 analysis/lumbar puncture 215

Index

ceruloplasmin levels 104, 111 complex regional pain syndrome comatose patient investigation 18 cervical myelopathy 125 (CRPS) 134 confusion diagnostic testing 4 Charcot–Marie–Tooth (CMT) disease comprehension assessment, aphasia 23 CSF tap test 36 121, 122, 124 COMT (catechol-O- dementia evaluation 33 chemotherapeutic agents, related methyltransferase) inhibitors Devic’s disease 201 polyneuropathy 124 106, 107 diplopia diagnostic testing 56 Cheyne–Stokes breathing 17 conduction aphasia 25 headache investigation 150 chlordiazepoxide 6 conduction block 87, 88 lumbar puncture technique 7 chloroquine 84, 124 multifocal motor neuropathy with meningitis diagnosis 6–9 cholesytramine 84 (MMNCB) 94 multiple sclerosis (MS) cholinergic crisis 99 confrontation naming 24 investigation 200 chorea 114–115, 117 confusion post-lumbar puncture headache choroidal artery 181 causes of 181 155 chronic daily headache (CDH) diagnostic testing 4 pseudotumor cerebri investigation/ 156–157 differential diagnoses 2–4, 22, 182 treatment 152–153 chronic inflammatory demyelinating etiologies 4–10 rapidly progressing weakness polyradiculoneuropathy (CIDP) examination 1–2 investigation 98 86, 124 general treatment approach 10 seizure investigation 163, 165 chronic paroxysmal hemicrania history 1 CT (computed tomography) scanning (CPH) 154 variations of 1 coma investigation 17 chronic progressive external constipation, Parkinson’s disease 107 computed tomographic ophthalmoplegia (CPEO) 57 conus medullaris syndrome 92 angiography (CTA) 186, 189 Churg–Strauss syndrome 100 conversion disorder confusion diagnostic testing 4, 10 ciliary ganglion lesions 60 coma differentiation 18 dementia diagnosis 32 circumlocution 23, 25 dementia differentiation 38 intracranial mass lesions 212 Claude’s syndrome 53 gait abnormalities 146 pre-lumbar puncture 7 claudication 139 generalized pain disorders 127 seizure investigation 163 clonazepam seizure differentiation 162, 171 stroke investigation 184, 186, 189, hyperkinetic movement disorders visual loss 47–48 193 treatment 111, 113, 115, 117 copper-deficiency myelopathy 142, 202 subarachnoid hemorrhage findings parkinsonism treatment 105 corpus callosotomy 174 150 performance anxiety 111 cortical sensory modalities 121 subdural hematoma (SDH) 183 clopidogrel 190 corticobasal ganglionic degeneration cyclophosphamide 100, 204 clozapine 34, 107 108 cyclosporine 111 cluster headaches 154, 158 examination 103–104 cytarabine 9 cocaine 18, 111 history 102–103 cytomegalovirus 138, 140 Coccidioides immitis 9 symptoms 27, 32, 37, 102 coccygodynia 141 cramps 81, 115, 126 dantrolene 205 cognitive dysfunction cranial nerve examination 32 de Quervain’s tenosynovitis 131 dementia. See dementia cranial polyneuropathy 55 decerebrate posturing 16 evaluation. See mental status craniectomy, decompressive 192 decorticate posturing 16 examination creatine kinase (CK) deep brain stimulation (DBS) 106, mild cognitive impairment (MCI) 37 iatrogenic myopathies 84 107, 110, 112, 115 multiple sclerosis (MS) 205 inflammatory myopathies83 deep vein thrombosis (DVT) processing speed 31, 104 proximal weakness 81 prophylaxis 191 colchicine 84, 124 rapidly progressing weakness 101 delirium 1, 178 cold caloric testing 15, 18 thryoid myopathies 84 delirium tremens 5 colon cancer 133 Creutzfeldt–Jakob disease (CJD) 38–39 dementia coma dementia 28, 38–39 Alzheimer’s disease. See Alzheimer’s anoxic myoclonus 113 myoclonus 32, 113 disease (AD) brain death diagnosis 19–20 parkinsonism differentiation 102, 104 causes of 33 causes of 181 seizure 166 diagnostic testing 32–33 examination 12–17 critical illness myopathy (CIM) 101 examination 28–32 Glasgow Coma Score (GCS) 193 critical illness polyneuropathy (CIP) frontotemporal. See frontotemporal history 12 100–101 dementia (FTD) increased intracranial pressure 20–21 Cryptococcus neoformans 9 history 27, 28 investigations 17–18 CSF analysis/lumbar puncture mimics of 28, 37–38 persistent vegetative state (PVS) 19 chronic inflammatory demyelinating multiple sclerosis (MS) 205 prognostication in 18 polyradiculoneuropathy myoclonus and 113 somnolence preceding 1 (CIDP) 87 parkinsonism 103, 104, 107, 108 216

Index

subacute and rapidly progressive dopamine agonists encephalitis 38–39 dementia with Lewy bodies (DLB) Bickerstaff’s brainstem55 sudden-onset 181 treatment 34 investigations 163 symptoms 27–28 Parkinson’s disease treatment 105, limbic 9 vascular 28, 33, 35 106, 107 occult 17 with Lewy bodies. See dementia restless legs syndrome (RLS) use 126 seizures and 165 with Lewy bodies (DLB) tremor treatment 112 viral 7 dementia with Lewy bodies (DLB) dopamine antagonists, drug-induced encephalomyelitis examination findings28 , 29, 32 parkinsonism 103, 108 acute disseminated 98 parkinsonism 103, 109 double simultaneous extinction 3 segmental myoclonus 113 symptoms 9, 27–28, 34 drug abuse 4, 18, 103 encephalopathy treatment 34 Duchenne’s muscular dystrophy coma differentiation 12, 15, 16 demyelinating disorders. 200–201, (DMD) 83 confusion and 4–6 See also multiple sclerosis (MS) duloxetine 125, 134 Hashimoto’s 28, 39 depression dysarthria 65 hepatic 2, 4, 6, 112, 165 dementia differentiation 37 anatomy 62 hypertensive 153 generalized pain disorders 127 aphasia differentiation 22, 23 transtentorial herniation multiple sclerosis (MS) 205 parkinsonism 103, 107, 108 differentiation 20 Parkinson’s disease (PD) 106 dysphagia 66 Wernicke’s 5, 36, 54 seizure differentiation 162 anatomy 62 enolase, neuron-specific19 dermatochalasis 58 facial weakness and 64 entacapone 106 dermatomyositis 79, 83 parkinsonism 107 enteroviruses 7 Devic’s disease 45, 200–201 stroke management 191 enzyme-linked dexamethasone 6, 156 weakness and 79, 81 immunoelectrotransfer blot dextroamphetamine 38 dysphonia 65 assay 213 diabetes dystonia 115, 116–117 epicondylitis 129, 130 diabetic amyotrophy 133 dystonic tremor 112 epidural cord compression 139–140 inflammatory radiculopathy140 dystrophinopathies 19 epilepsy. See seizures and epilepsy polyneuropathy 123 Epley particle-repositioning seizures 165 echocardiography 188, 204 maneuvers 74 stroke risk 189 echolalia 25 Erb’s palsy 128 dialysis disequilibrium 165 eclampsia 10, 166 erythema 9, 83 diazepam 6, 116, 156, 175, 205 edema erythrocyte sedimentation rate (ESR), diclofenac 134 papilledema 44 temporal arteritis 45 digit span test 2 vasogenic 10, 208 essential myoclonus 113 dihydroergotamine 156 edrophonium test 55 essential tremor 110 dimercaprol 100 electroconvulsive therapy (ECT), ethanol intoxication/withdrawal. dimercaptosuccinic acid 100 Parkinson’s disease use 107 See alcohol abuse diphenhydramine 115 EEG electroencephalography ethosuximide 167, 171 diphtheria 96, 100 comatose patient investigation 17 ethylene glycol intoxication 19, 45 diplopia confusion diagnostic testing 4 evoked potentials. See nerve causes of 56, 197–198 hepatic encephalopathy 6 conduction studies (NCS) diagnostic testing 56 pentobarbital coma 175, 176 exercise testing 79–80, 82 establishing binocularity and seizure investigation 164, 170, 171, eye movements and position direction of 49 172 comatose patient examination 14–16 localizing 49 electroconvulsive therapy (ECT), facial weakness and 64 ocular misalignment inspection 49 Parkinson’s disease use 107 opsoclonus–myoclonus 113 treatment 56 electrolyte abnormalities 164, 167 parkinsonism 104, 108 weakness and 79, 81 electromyography (EMG) progressive supranuclear palsy dipyridamole 190 foot drop 93 (PSP) 108 disc herniation 138 parkinsonism use 105 rapidly progressing weakness disulfiram 124 polyneuropathy evaluation 123 examination 96 Dix–Hallpike maneuver 72, 73 proximal and generalized weakness eyelid disorders dizziness 82, 85, 88 blepharospasm 59 chronic undifferentiated76 rapidly progressing weakness eyelid-opening apraxia 59 imbalance. See imbalance 97–98, 101 lid retraction 58–59 lightheadedness 69–70 shoulder and arm pain progressive supranuclear palsy meaning of 69 investigation 128 (PSP) 108 vertigo. See vertigo eletriptan 154 ptosis 56, 57–59 donepezil 33, 34, 107, 205 emotional incontinence 66 ezetimibe 84 217

Index

facial movement abnormalities restless legs syndrome (RLS) head trauma 116–117 treatment 126 coma and 17 facial nerve, dysarthria and lesions seizure management 167, 168 postconcussion syndrome 38 of 65 gag reflex67 posttraumatic seizures 165 facial pain 157–158 gait abnormalities subdural hematoma (SDH) 183 facial weakness dementia and 28, 32, 33, 35 headache anatomy 62 examination 144–145 “benign” 153–156, 158 causes of 64–65, 197 falls prevention 147–148 dangerous subacute and chronic examination 62–64 frontal gait disorder 35 syndromes 152–153 eyelid disorders. See eyelid history 144 dangerous sudden-onset syndromes disorders multiple sclerosis (MS) 197 150–152, 182 factor IX complex 192 parkinsonism 102, 103, 106, 108 epidemiology 148 falls patterns of 145–147 evaluation 148–150 gait abnormalities and. See gait Trendelenburg gait 81 facial pain presentation 158 abnormalities weakness and 81 history 148 parkinsonism 102, 106, 108 galantamine 33, 34 pregnancy and 155–156 prevention 147–148, 192 gamma knife radiosurgery 157 head-thrust maneuver 15, 72 fasciculations 87, 113–114 gemfibrozil 84 hearing problems fatigue general paresis of the insane (GPI) 37 facial weakness and 62, 64 fluctuating diplopia55 genetic testing, dementia 33 vertigo and 73, 75 multiple sclerosis (MS) 205 glabellar sign 32 heavy metal intoxication 97, 98, 100 muscle fatigability 79 Glasgow Coma Score (GCS) 193 heel–knee–shin test 71 weakness mimicry 78 glatiramer acetate 203, 204 hematin 100 femoral neuropathy 92 glial tumors 208–209 hemianopsia 43, 44, 46–47 fentanyl 134 glioblastoma multiforme 208 hemiballismus 113, 162 festination 146 global aphasia 25 hemifacial spasm 117 fibromyalgia127 , 134, 158 glossopharyngeal nerve lesions 67 hemiparesis/hemiplegia finger-to-nose test71 glossopharyngeal neuralgia 157–158 ataxic 182 Finkelstein test 131 glutamic acid decarboxylase eye deviation and 14 flaccidity 78 antibodies 116 pathology localization 93–94 fluconazole9 golf elbow 130 stroke. See stroke fludrocortisone69 , 70 gonyalgia paresthetica 133 heparin, reversal of 192 fluorescent treponemal antibody Gottron’s papules 83 hepatic dysfunction 18, 111 absorption (FTA-ABS) test 37 Gowers’ sign 144 hepatic encephalopathy 4, 6, 112, 165 fluoxetine163 GQ1b antibodies 55 asterixis test 2 fluphenazine 117 Gradenigo syndrome 51 hereditary neuropathy with liability fluvastatin 84 grasp sign 31 to pressure palsies (HNPP) 94 foot drop 92, 146 Graves’ disease 55, 58–59 hereditary spastic paraplegia (HSP) forced vital capacity (FVC) 96 Guillain–Barré syndrome (GBS) 142, 202 fosphenytoin 175 coma mimicry 18 herpes simplex virus (HSV) fresh frozen plasma (FFP) 192 conduction block 87 Bell’s palsy 64 frontal eye fields (FEF) 14 creatine kinase (CK) levels 81 encephalitis 7 frontal release signs 31 examination findings98 radiculopathy 140 frontotemporal dementia (FTD) investigation findings97 , 98 herpes zoster virus 64, 140, 158 34–35 poliomyelitis differentiation100 highly active antiretroviral therapy age of onset 28 symptoms 96, 98 (HAART) 37 examination findings28 , 29, 32, 34 treatment 98–99 hip problems 92, 132–133 seizure and 166 HIV/AIDS symptoms 27, 34 Haemophilus influenzae6 chorea 115 frovatriptan 154 hallucinations chronic inflammatory functional MRI (fMRI), dementia dementia with Lewy bodies (DLB) demyelinating use 32 27, 34 polyradiculoneuropathy migraine auras 149 (CIDP) and 87 gabapentin narcolepsy 162 dementia 37 hyperkinetic movement disorders Parkinson’s disease (PD) 107 polyneuropathy 124 treatment 111, 115 seizures 162 viral meningitis and 7 migraine prophylaxis 154 haloperidol 10, 113, 117 Hollenhorst plaques 184 neuropathic pain management 125, hand pain 129 homocysteine levels 141 138, 157, 158 hand weakness 63, 64, 90–92, 182 Horner’s syndrome 57, 60–61 renal dysfunction and 169 Hashimoto’s encephalopathy 28, 39 brachial plexopathy and 89, 130 218

Index

carotid artery dissection and 151 papilledema 44 Kayser–Fleischer (KF) rings 111 coma and 13 surgical hematoma evacuation Kernig’s sign 6 human T-cell leukemia virus (HTLV) 192–193 Kernohan’s notch phenomenon 20 142 indomethacin 154 ketamine 19, 156, 157 Huntington’s disease (HD) 103, 104, inflammatory myopathies82–83 ketorolac 134, 156 109, 114, 115 creatine kinase (CK) levels 81, 83 knee pain 133 hydralazine 192 steroid myopathy and 84 Korsakoff’s dementia36–37 hydrocephalus insulin neuritis 123 normal pressure. See normal interferon beta. See beta interferon L’hermitte’s symptom 197 pressure hydrocephalus internal carotid artery (ICA) stroke labetalol 188, 192 hydrocodone 134 syndromes 179–180 lactate levels 82 hydromorphone 134, 156 internuclear ophthalmoplegia (INO) lactulose 6, 107 hydroxychloroquine 84 52, 197 lacunar strokes 182 hypercalcemia 4, 18 intracranial hemorrhage (ICH) 4, Lafora body disease 113 hypercarbia 4 182, 192–193 Lambert–Eaton myasthenic hypercoagulable states 189 intracranial mass lesions syndrome (LEMS) 67, 79, 80, 86 hyperglycemia 4, 18, 183, 191. cerebellopontine angle (CPA) 211 lamotrigine 167, 168, 169, 173 See also diabetes headache 152 drug interactions 172–174 hyperkinetic movement disorders, in immunocompromised patients Lance–Adams myoclonus 113 110–117. See also specific disorders 211–212 language hyperlipidemia 189 seizure 166 aphasia. See aphasia hypernatremia 18 sellar region 211 confusion and problems with 2 hypertension supratentorial, brain stem and dementia-related problems 27, 28 hypertensive encephalopathy 153 cerebellar 208–211 dysarthria. See dysarthria iodiopathic intracranial 152 tropics and developing world examination of 28 MAO-B inhibitors and 105 212–213 lateral geniculate lesions 44 stroke management/prevention intracranial pressure, increased. lead poisoning 98, 100, 122 188, 189, 192, 193 See increased intracranial Leber’s hereditary optic neuropathy hyperthermia, stroke management pressure (LHON) 45, 203 191 intravenous immunoglobulin (IVIg) leg pain 132–133, 136 hyperthyroidism 4, 18, 84, 111, 115, chronic inflammatory leg weakness 64, 92–94 124 demyelinating Lennox–Gastaut syndrome (LGS) hyperventilation 17 polyradiculoneuropathy 172, 174 hypocalcemia 164 (CIDP) 87 leptomeningeal metastasis 39 hypochromia iridis 59 diabetic amyotrophy 133 leukemia 87 hypoglossal nerve lesions 65, 66 encephalitis treatment 9 leukoaraiosis 35 hypoglycemia 4, 18, 111, 183. Guillain–Barré syndrome (GBS) 98 leukocyte arylsulfatase A levels 142 See also diabetes Lambert–Eaton myasthenic levetiracetam 167, 168, 169, 173 hypohydrosis 108 syndrome (LEMS) levodopa hypomagnesemia 165 treatment 86 corticobasal ganglionic hyponatremia 4, 18, 164 meningitis treatment 9 degeneration treatment 28 hypophosphatemia 165 Miller–Fisher’s syndrome (MFS) dementia with Lewy bodies (DLB) hypotension treatment 55 treatment 34 orthostatic 69, 104, 105, 108 multifocal motor neuropathy with eyelid disorder treatment 59 spontaneous intracranial (SIH) conduction block (MMNCB) multisystem atrophy (MSA) 155 treatment 94 treatment 108 hypothermia, coma prognostication multiple sclerosis (MS) Parkinson’s disease (PD) treatment and 19 management 204 105–106, 107 hypothyroidism 4, 18, 81, 84, 124 myasthenia gravis treatment 67, 99 parkinsonian tremor efficacy112 hypoxia 4 stiff person syndrome treatment progressive supranuclear palsy hypoxic–ischemic injury 17 116 (PSP) treatment 108 intravenous recombinant tissue restless legs syndrome (RLS) ibuprofen 138 plasminogen activator treatment 126 imbalance 70, 76, 121 (IV rt-PA) 186–187 levothyroxine 111 inclusion body myositis (IBM) 83 intubation, assessment for 96 lidocaine 125, 154, 156, 157 incoherence 1 iris lesions 60 lightheadedness 69–70 incontinence 138, 140, 197, 205 limb-girdle muscular dystrophies increased intracranial pressure joint position perception 121 (LGMD) 81, 84 20–21 juvenile myoclonic epilepsy (JME) limbic encephalitis 39 abducens nerve palsy 51 113, 170 line bisection test 2–3 219

Index

Listeria monocytogenes 6 confusion and 6–9 mitochondrial disorders 85, 202 lithium 111, 154 drug-induced 9 mitoxantrone 204 liver function tests 4, 83 fungal 9 mixed transcortical aphasia 25 locked-in state 99 Lyme 9 modafinil163 , 205 long thoracic neuropathy 90 neoplastic 6, 8 monoclonal gammopathy 123 lorazepam 6, 9, 73, 111, 175 seizures and 163, 165 mononeuropathy multiplex 94, 124 Lorenzo’s oil 142 tuberculous 9 months of the year backwards test 1 lovastatin 189 viral 6, 7, 152 morphine 134, 156 lumbosacral plexopathy 92, 132–133 mental status examination Morton’s neuroma 126 lumbosacral polyradiculopathy 125 coma 12 motor neuron disease (MND) lung cancer dementia 28 amyotrophic lateral sclerosis (ALS) anisocoria and 60 parkinsonism 104 dysarthria. See amyotrophic brachial plexopathy and 128–129 rapidly progressing weakness 96 lateral sclerosis (ALS) Lambert–Eaton myasthenic meperidine 134 dysphagia and 66 syndrome (LEMS) and 86 meralgia paresthetica 132 frontotemporal dementia (FTD) Luria test 30–31 metabolic insult causing re- and 32 Lyme disease 9, 87, 140, 202 expression of old stroke motor system, anatomy of 89 lymphoma 87, 202, 209 (MICROS) 182–183 MRI (magnetic resonance imaging) metachromatic leukodystrophy arteriovenous malformations malignant middle cerebral arteny (MLD) 142, 202 (AVM) 210 (MCA) syndrome 178, 188 metastatic cord compression back and neck pain investigation malingering 139–140 138, 140, 142 coma mimicry 18 metastatic tumors, cerebral. brain tumors 209, 210 dementia mimicry 38 See cerebral metastases comatose patient investigation 17 gait abnormalities 146 methadone 125, 134 confusion diagnostic testing 4 generalized pain disorders 127 methanol intoxication 19, 45 dementia diagnosis 32, 36 seizure differentiation 162, 171 methotrexate 9, 83, 204, 209 diplopia diagnostic testing 56 sensory symptoms and 119 methylmalonic levels 141 facial pain investigation 157 visual loss 47–48 methylphenidate 38, 163, 205 functional (fMRI) 32 manganese 103 methylprednisolone headache investigation 155 MAO-B inhibitors 105, 106, 107 diabetic amyotrophy treatment 133 HSV encephalitis 7 Marburg variant MS 206 multiple sclerosis (MS) intracranial mass lesions 210, 212 meclizine 73 management 201–203, 204 magnetic resonance angiography medial longitudinal fasciculus (MLF) optic neuritis treatment 201–203 (MRA) 186, 189 50, 52 metoclopramide 103, 108, 117 magnetic resonance spectroscopy medication-induced disorders metronidazole 124 (MRS) 32 chorea 114 mexiletine 116 multiple sclerosis (MS) findings confusion 4, 9 microvascular decompression 157, 198–200 drug-induced meningitis 9 158 neoplastic meningitis 8 drug-induced parkinsonism 102, midazolam 175 parkinsonism investigation 104 103, 108–109 midbrain lesions 12, 14, 15 posterior reversible encephalopathy headache 155 middle cerebral artery (MCA) stroke syndrome (PRES) 10 myoclonus 112 syndromes 178, 188 rapidly progressive weakness myopathies 84 midodrine 69, 70 investigation 97 polyneuropathy 124 migraine seizure investigation 163 secondary tremor 111 aura 46, 149, 153, 183 stroke investigation 184–186 seizure 165 diagnosis 153 vertigo investigation 73 vertigo 75 facial pain presentation 158 Muller’s muscle 57 Meige’s syndrome 59, 117 pregnancy and 156 multifocal motor neuropathy with memantine 33, 34 prophylaxis 153–154 conduction block (MMNCB) 94 memory seizure differentiation 162 multi-infarct dementia 35 confusion and problems with 2 status migrainosus 156 multiple myeloma 123 dementia-related problems 27, 29, subarachnoid hemorrhage multiple sclerosis (MS) 33, 35, 36 differentiation 151 atypical symptoms 198 examination of 29 treatment 153 clinically isolated syndromes (CIS) transient global amnesia (TGA) 3, 183 vertigo and 74, 76 197–198, 201 Ménière’s disease 74, 76 mild cognitive impairment (MCI) diagnostic process 198–200 meningiomas 209, 211 37 differential diagnoses 198, meningitis Miller Fisher’s syndrome (MFS) 55 200–201 bacterial 6–7, 152 mirtazapine 154 dysarthria 65 220

Index

facial weakness 65 neomycin 6 ophthalmic artery occlusion 46 fulminant 206 nerve conduction studies (NCS) ophthalmoplegia 5, 15, 52, 54, 57, MRI findings198–200 chronic inflammatory 197 multifocal presentation 198 demyelinating opioid intoxication 12 myokymia 116 polyradiculoneuropathy opsoclonus 72 progressive 198, 204 (CIDP) 86, 87 opsoclonus–myoclonus 113 relapsing–remitting (RRMS) 204 comatose patient investigation 19 optic neuritis 44–45, 197, 200–203 segmental myoclonus 113 multiple sclerosis (MS) optic neuropathies 45–46 summary of disease stages 197 investigation 200 orbit lesions 51, 52, 55 symptomatic treatment 204–206 polyneuropathy evaluation 123 oromandibular dystonia 116 trigeminal neuralgia 157 proximal and generalized weakness orthostatic hypotension 69, 104, 105, tumefactive 210–211 investigation 82 108 vertigo 76 rapidly progressing weakness oscillopsia 71 multisystem atrophy (MSA) 97–98, 99, 101 osteoarthritis 129, 132, 133 examination 103–104 repetitive nerve stimulation (RNS) osteosclerotic myeloma 87 history 102–103 85 ovarian cancer 133 investigations 104–105 neurocysticercosis 166, 212 overlap myopathies 83 symptoms 65, 69, 72, 102, 108 neurolabyrinthitis 73 overshoot 71 treatment 108 neuromuscular junction blockade, oxaprozin 134 muscle atrophy, proximal weakness prolonged 101 oxcarbazepine 157, 167, 168, 169, and 79 neuromyelitis optica 45, 200 173 muscle-specific tyrosine kinase neuronal ceroid lipofuscinosis 113 oxybutinin 205 (MuSK) antibodies 85 neurosyphilis 37 oxycodone 134, 138, 156 muscular dystrophies 81, 83–84, 116 niacin 84 oculopharyngeal muscular nitroglycerin, topical 127 pain dystrophy (OPMD) 57, 65, 67, NMDA receptor antagonists 33 antalgic gait 146 79, 81 NMDA receptor antibodies 9 arm/hand 128, 136 myasthenia gravis nonarteritis ischemic optic causes of distal/generalized coma mimicry 18 neuropathy (NAION) 45 neuropathic 121–127 generalized 85–86 nonconvulsive status epilepticus character of 119 muscle fatigability testing 79–80 (NCSE) 9–10, 18 dementia misdiagnosis and 38 myasthenic crisis 86, 98, 99 nonsteroidal anti-inflammatory drugs head. See headache ocular 56 (NSAIDs) 9, 134, 156 leg 132–133, 136 ocular symptoms 49, 56, 57, 72 normal pressure hydrocephalus multiple sclerosis (MS) 205–206 oropharyngeal symptoms 65, 67 (NPH) 33, 35–36 myopathy and 79 proximal weakness 79–80 nortriptyline 125, 138 neuropathic pain management 124 steroid myopathy and 84 noxious stimuli 12 nociceptive pain management mycophenolate mofetil 85, 99 nucleus pulposus herniation 138 133–134 myelopathy 136–137 numbness sensory system anatomy 119 neurological 137–140 aura symptoms 149 shoulder 128–129 non-neurological 140–143, 197 causes of distal/generalized summary of causes of limb pain spastic gait 145 121–127 129 Myerson’s sign 32 facial 157 weakness mimicry 78 myoclonus 32, 38, 112–113 meaning of 119 palatal tremor 112 myoedema 81 nystagmus 71–72, 73 pallidotomy 106 myofascial pain syndrome 134, 158 palmomental sign 31 myoglobinuria 79 obstructive sleep apnea (OSA) 37 Pancoast tumor 60, 61 myokymia 116 obturator neuropathy 92 papilledema 44 myotonia 81, 116 occipital neuralgia 155 paraneoplastic cerebellar myotonia congenita 81, 116 oculocephalic reflex104 degeneration 76 myotonic dystrophy 81, 116 oculocephalic responses 15–16 paraphasic errors 23 oculomotor nerve (third nerve) paratonia 32, 79 naratriptan 154 lesions 52, 54, 57 parcopa 107 narcolepsy 162–163 oculopharyngeal muscular dystrophy paresthesia narcotic analgesics 134, 138, 156, 157 (OPMD) 57, 65, 67, 79, 81 causes of 89, 90, 92, 121, 128, natalizumab 204 oculosympathetic nerve dysfunction 129–132 negative inspiratory force (NIF) 96 57 meaning of 119 neglect 2–3, 178 olanzapine 117 multiple sclerosis (MS) treatment Neisseria meningitidis 6 oligoclonal bands (OCBs) 200, 201 205 neologisms 23 oligodendrogliomas 208 Parinaud’s syndrome 59 221

Index

parkinsonism pituitary masses 211 primary lateral sclerosis 67 dementia with Lewy bodies (DLB) plantar fasciitis 126 primidone 110, 111 32, 34 plantar neuropathy 126 processing speed 31, 104 drug-induced 102, 103, 108–109 plasmapheresis progressive multifocal examination 103–104 chronic inflammatory leukoencephalopathy (PML) history 102–103 demyelinating 202, 204 investigations 104–105 polyradiculoneuropathy progressive supranuclear palsy (PSP) multisystem atrophy (MSA). (CIDP) 87 examination 32, 103–104 See multisystem atrophy Guillain–Barré syndrome (GBS) 98 history 102–103 (MSA) Miller Fisher syndrome (MFS) 55 investigations 104–105, 108 Parkinson’s disease (PD). multiple sclerosis (MS) 204 symptoms 37, 59, 65, 72, 107–108, See Parkinson’s disease (PD) myasthenia gravis 67, 86, 99 146 progressive supranuclear palsy pleocytosis 6–9, 201 treatment 108 (PSP). See progressive pneumonia 4 prolactinomas 211 supranuclear palsy (PSP) POEMS syndrome 87, 123 propofol 175 symptoms 72, 91, 112 polar artery 181 propranolol 110, 111, 154 vascular 109 poliomyelitis 98, 100 protamine sulfate 192 Parkinson’s disease (PD) polyarteritis nodosa 100 protein electrophoresis 123 constipation 107 polyethylene glycol 107 proximal weakness dementia 37, 107 polymyalgia rheumatica 45, 152 associated features 79, 144, 146 diagnosis 105 polymyoclonus 16 causes 82–88 disease progression 105 polymyositis 83 examination 79–81 dysarthria 65, 107 polyneuropathy history 79 dysphagia 67, 107 cramps 115 investigations 81–82 examination 103–104 cranial 55 Prussian blue 100 eyelid disorders 59 etiologies 123–124 pseudobulbar state 65, 66 gait abnormalities 145–146 evaluation 119 pseudotumor cerebri 152–153 hallucinations and psychosis 107 length-dependent 122 psychogenic disorders history 102–103 non-length-dependent 122 coma differentiation 18 investigations 104–105 pontine lesions 12, 14, 15 dementia differentiation 38 orthostatic hypotension 69 porphobilinogen 98 gait abnormalities 146 treatment 105–107 porphyria 97, 100, 122 generalized pain disorders and tremor 112 positron emission tomography (PET) 127 Parsonage–Turner syndrome 129 32 multiple sclerosis (MS) penicillamine 84 postconcussion syndrome 38, 76 differentiation 198 pentobarbital coma 175, 176 posterior cerebral artery (PCA) seizure differentiation 162, 171 perilymph fistula75 infarction 47, 181 stroke mimicry 183 periscapular weakness 90 posterior communicating artery tremor 112 periventricular white matter disease (PCOM) aneurysm 59, 60 visual loss 47–48 35 posterior inferior cerebellar artery psychosis 4, 107, 162 peroneal neuropathy 92, 93, 95 (PICA) 181 ptosis 56, 57–59, 79, 81, 96 persistent vegetative state (PVS) 19 posterior reversible encephalopathy pupillary reactions Phalen’s sign 131 syndrome (PRES) 10, 17, 47 anisocoria 59–61 phencyclidine 19, 111 postpartum leg weakness 92 coma examination 12 phenobarbital 168, 169, 172–174, 175 postural tachycardia syndrome rapidly progressing weakness phenytoin (POTS) 70 examination 96 drug interactions 172–174 potassium channel (voltage-gated) relative afferent pupillary defect hyperkinetic movement disorders antibodies 9 (RAPD) examination 42–43 treatment 116 pramipexole 105, 126 uncal herniation and dilatation 20 neuropathic pain management 157 pravastatin 84, 189 visual loss examination 42–43 polyneuropathy inducement 124 praxis, deficits in.See apraxia pure autonomic failure 69 renal dysfunction and 169 prednisone 83, 85, 100, 156, 201 pure motor lacune 182 seizure management 165, 167, pre-eclampsia 166 pure sensory lacune 182 168–169, 171 pregabalin 125, 134, 157 pyridostigmine 56, 67, 85, 86 phosphocreatine 81 pregnancy pyridoxine 124 physiological tremor, enhanced 111 headache in 155–156 pyrimethamine 212 pinprick examination 119 post partum leg weakness 92 pins and needles 119. pre-eclampsia and eclampsia 166 quadrantanopsia 44, 46–47 See also paresthesia primary central nervous system quetiapine 10, 34, 107 pituitary apoplexy 46, 151 lymphoma (PCNSL) 209, 212 quinine 115 222

Index

radial neuropathy 91–92 progressive supranuclear palsy seizure differentiation 162 radiation therapy 8 (PSP) symptom 108 sensory system anatomy 119 radiculopathy treatment 105–106 stroke syndromes 178–180 back and neck pain 137–140 riluzole 88 treatment 124 focal limb weakness 89, 91, 92, 93 risperidone 117 weakness mimicry 78 focal pain syndromes 128, 129, 130, rivastigmine 33, 34, 107 septic cavernous sinus thrombosis 132, 133 rizatriptan 154 54 inflammatory 140 rohypnol 19 serial sevens test 2 muscle weakness by myotomes Romberg’s sign 122, 145 shoulder pain 128–129 summary 137 rooting reflex31 shoulder weakness 89–90 overview 136 ropinirole 105, 126 simvastatin 84, 189 sensory loss by dermatomes rotator cuff tendonitis129 single photon emission computed summary 137 tomography (SPECT) 32 summary of limb pain causes 129 sacroiliac joint dysfunction 141 sinus headache 158 radiofrequency ablation (RFA) 157 saphenous nerve 133 Sjogren’s syndrome 122, 202 rasagiline 105 sarcoidosis 87, 123, 140, 202 skew deviation 52 rashes 83 Saturday night palsy 91, 182 sleep disorders 37 Raynaud’s phenomenon 127 scapular winging 90 snout reflex31 reading deficits24 , 47 schwannomas 211 somatosensory neglect 3 rebound 71 sciatic neuropathy 93 somnolence 1 recombinant tissue plasminogen scotoma 43, 46 spasticity 78, 145, 204–205 activator (rt-PA), intravenous sedatives, coma examination/ Spetzler–Martin AVM Grading Scale 186–187 investigations and 12, 19 211 reflexes seizures and epilepsy sphincter dysfunction 108, 138 amyotrophic lateral sclerosis (ALS) brain tumors and 208 spinal accessory neuropathy 90 abnormalities 81, 87 differential diagnoses 149, 161–163 spinal cord anatomy 136 blink 13–14 epilepsy treatment 169–175 spinal cord infarction 142–143 chronic inflammatory epileptic dizziness 75 spinal fractures 141 demyelinating eye deviation 14 spinal stenosis 92, 132, 139 polyradiculoneuropathy first-time seizure160 , 163, 167–169 spirometry 96 (CIDP) 86 headache and 149 spondylosis, cervical 202 primitive 31 ictal semiology 160–161 spontaneous intracranial hypotension proximal weakness examination multiple sclerosis (MS) and 211 (SIH) 155 80 nonconvulsive status epilepticus Spurling’s test 136 rapidly progressing weakness (NCSE) 9–10, 18 statins 189, 190 examination 96 seizure etiology determination 163 statin-induced myopathy 84 snout/rooting 31 specific seizure etiologies 113, stenting, carotid artery 191 relative afferent pupillary defect 164–166 stereognosis 121 (RAPD) 42–43 status epilepticus 175–176 steroid therapy. Seealsospecific drugs renal dysfunction 18, 165, 169 Todd’s paralysis 183 Bell’s palsy use 64 repetition 24, 25 selective serotonin reuptake disc herniation 138 respiratory failure, neuromuscular inhibitors (SSRIs) 35, 134, 205 inflammatory myopathy 96 MAO-B inhibitors and 105, 107 treatment 83 respiratory patterns, coma selegiline 105 lymphoma and 209 examination 17 sellar lesions 46 myasthenia gravis treatment 85, restless legs syndrome (RLS) 126 sensory examination 99 retinal artery occlusion 203 dementia assessment 32 neoplastic meningitis 8 retinal ischemia/infarction 44, 46 rapidly progressing weakness 96 nociceptive pain management 134 retroperitoneal hematoma 133 sensory symptoms status migrainosus treatment 156 rhabdomyolysis 79, 84 aura 149 steroid myopathy 84 rheumatoid arthritis 100 causes of distal and generalized temporal arteritis use 45 riboflavin154 121–127 Tolosa–Hunt syndrome use 54 rifaximin 6 examination 122, 122 stiff person syndrome 116 right hemispheric syndrome 2–3 investigations 123 stimulant drugs 38 rigidity multiple sclerosis (MS) 197, “stocking and glove” sensory loss 122 definition of79 205–206 stool tests, rapidly progressing examination 103 myelopathy 137 weakness 98 Huntington’s disease (HD) 114 overview 119 straight leg raise test 136 meningitis and nuchal 6 proximal weakness and 81 strategic infarct dementia 35 Parkinson’s disease symptom 105 radiculopathy 136, 137 Streptococcus pneumoniae 6 223

Index

stroke thoracic outlet syndrome 130 twitching 113–114 aphasia and 22, 26 thymectomy 85 two-point discrimination 121 carotid artery dissection and 151 thymoma 85 cerebral venous sinus thrombosis ticlopidine 190 ulnar neuropathy 90–91, 95, 129, 182 (CVST) and 152 tics 117 uncal herniation 12, 20, 59, 60 common syndromes 178–182 Tinel’s sign 130, 131 uremia 111, 112, 165 confusion and 10 tinnitus 75 urinary tract infection 4 differential diagnoses 91–92, 149, tissue plasminogen activator (tPA) urine tests 4, 98, 104 182–184 186–187 examination 184 tizanidine 205 vagus nerve lesions 65, 67 eye deviation 14 Todd’s paralysis 183 vagus nerve stimulator (VNS) 174 facial weakness 62–64 tolcapone 106 valacyclovir 64, 158 hand weakness 91–92 Tolosa–Hunt syndrome 54 valproate investigations 184–186, 188–189 tolteridone 205 drug interactions 172–174 pathology localization 93–94 topiramate myoclonus treatment 113 related dementia. See dementia, drug interactions 172 renal dysfunction and 169 vascular migraine prophylaxis 154 seizure management 167, 168, secondary prevention 189–191 neuropathic pain management 125 172–174 seizures and 166 renal failure and 169 valproic acid 1442113, 154 supportive care 191–192 seizure management 167, 168, 172 vancomycin 6 treatment 186–188, 192–193 tremor management 111 vasculitis vascular parkinsonism 109 toxoplasmosis 212 multiple sclerosis (MS) vertigo 73 Trails B-type test 31 differentiation 202 Stroop test 31 tramadol 125, 134, 138 peripheral nerve 100 subarachnoid hemorrhage (SAH) 6, transcortical motor aphasia (TCMA) polyneuropathy 123, 124 17, 150–151 25 rapidly progressive weakness 97 subcortical aphasias 25 transcortical sensory aphasia 25 vasculitic mononeuropathy subcortical white matter disease 35 transient global amnesia (TGA) 3, 183 multiplex 94 subdural hematoma (SDH) 4, 10, 183 transient ischemic attack (TIA), venereal disease research laboratory sulfadiazine 212 seizure differentiation 162 (VDRL) 37 sumatriptan 153 transtentorial herniation 20 venlafaxine 163 superior cerebellar artery (SCA) 181 transverse myelitis 141, 197, 200–201 verapamil 115, 154 superior sagittal sinus thrombosis 92 traumatic brain injury (TBI) 38. vertebrobasilar disease 73 Sydenham’s chorea 115 See also head trauma vertigo syncope 69–70, 161 tremor causes of 73–76, 181 syphilis 37 action/postural 110–111 examination 70 syringobulbia 67 classification of110 history 70 systemic lupus erythematosus (SLE) description of 110 imaging 73 115, 202 dystonic 112 vestibular nerve damage 15 intention 71, 102, 110, 112 vestibular neuritis 73, 76 Taenia solium 166 multiple sclerosis (MS) 198, 206 vibratory perception 119, 121 Tangier disease 122 neuropathic 112 visual abnormalities tardive dyskinesia (TD) 117 palatal 112 causes of 44–48, 179–180, 181, 184, target cancellation test 2–3, 31 parkinsonian 102, 103, 105, 112 197, 211 tarsal tunnel syndrome 126 psychogenic 112 examination 41–44 taste, facial weakness and 62, 64 resting 102, 103, 110, 112 eye movements and temperature perception 119, 120 treatment of 105 position. See eye movements temporal arteritis 45, 149, 152 Trendelenburg’s sign 81, 144 and position temporal crescent defects 44 trigeminal nerve lesions eyelid disorders. See eyelid temporomandibular joint (TMJ) dysphagia 66 disorders disease 158 trigeminal neuralgia 157, 197 headache and 149, 152, 153 tension headaches 154, 156, 158 trigeminal nerve, blink reflexes 13 history 41 tetrabenazine 117 trihexyphenidyl 105 monocular visual loss 43, 44 thalamotomy 106 trimethoprim-sulfamethoxazole 9 neglect 2–3 thalamic lesions 12, 14 triptans 153, 154, 156 visual field loss patterns43–44 thalamic strokes 18, 181 trochanteric bursitis 133 visual system neuroanatomy 41 thallium poisoning 98, 100 trochlear nerve palsy 52 visual strain headaches 155 theophylline 111 tropical spastic paraparesis 142, 202 visual system thiamine 5, 54, 100 tuberculoma 213 examination 32, 41–44, 184 Thomsen’s disease116 tuberculosis 9, 123 neuroanatomy of 41 224

Index

visuospatial deficits watershed infarction 179 Wernicke’s aphasia 2, 23, 24–25, 178 dementia 27, 30 weakness West Nile virus 98, 100 parkinsonism 104 aura symptoms 149 Wilson’s disease 110–111

vitamin B1 deficiency203 evaluation of 78 dystonia and 115 vitamin B12 deficiency32 , 123, 141, focal limb 95 history 102, 103, 109, 111 203 mimics of 78 investigations 105, 111 vitamin E deficiency122 , 202 multifocal 94–95 wrist drop 91 vitamin K 192 multiple sclerosis (MS) 197 writing deficits 24 numbness misinterpretation 119 Wallenberg’s syndrome 60, 61, 67, proximal. See proximal weakness X-ray, confusion diagnostic testing 4 73, 180 rapidly progressing 96–101 wall-eyed bilateral INO (WEBINO) stroke syndromes 178–180 zidovudine 84 52 Weber’s syndrome 53 zolmitriptan 153 warfarin 190, 192 Wernicke’s encephalopathy 5, 36, 54 zonisamide 105, 111, 168, 169, 172

225