INDEX

Dr William P. Howlett 2012 Index A – B

INDEX

A carbamazepine 91 abducens nerve 21, 295 diazepam 94 absence 79, 82 ethosuxamide 92 accessory nerve 27, 305 phenobarbitone 91 accommodation reflex 21, 289 phenytoin 91 acetylcholine receptor antibodies 320 sodium valproate 92 aciclovir 141 aphasia 51, 369 acoustic nerve 25, 303 apraxia 51, 369 balance 26, 303 Argyll-Robertson pupil 290 hearing 25, 303 Arnold-Chiari malformation 239 acoustic neuroma 377, 402 ART associated neuropathy 204, 268 activities of daily living (ADL) 251 astereognosis 59 acute bacterial (ABM) 123 asterixis 340 aetiology 124 astrocytoma 367 ceftriaxone 129 ataxia 54, 278, 404 chloramphenicol 129 339 clinical diagnosis 126 aura 81 CSF in ABM 129 AVPU method 217 diagnosis 128 axons 259 epidemiology 124 B Haemophilus influenzae type b (Hib) 125 34 management 129 Babinski sign , 48 See Neisseria meningitidis 125 bacterial meningitis. acute bacterial meningi- outcome 130 tis (ABM) 329 pathogenesis 126 basal ganglia 47, penicillin 129 Becker’s muscular dystrophy 314 204 prevention 130 Bell’s palsy , 268, 301 signs of meningitis 127 benign essential 337 Streptococcus pneumoniae 125 benign intracranial hypertension (BIH) 359 acute demyelinating (ADEM) benign paroxysmal positional vertigo (BPPV) 140 304 acute dystonic reactions 339 beriberi 278 acute epidural abscess 236 bladder 56 adjuvants 435 incontinence 56 agnosia 60 parasympathetic 56 AIDS 191 sympathetic 56 akinesia 330 Blantyre coma scale 166 149 akinetic-rigid syndrome 335 , 166, 194 alcohol 279 pyogenic 149 Alzheimer’s disease 387 toxoplasmosis 166, 194 amyotrophic lateral sclerosis (ALS) 341 tuberculoma 132, 194 analgesic overuse 356 brain death 225 54 management 356 brain stem 47, aneurysms 109 brain stem and cerebellum 369 anosmia 16, 287 brain tumours 367 anticholinergic drugs 335 chemotherapy 379 antiepileptic drugs 89 clinical features 368

444 Index C – C Index

focal neurological deficits 368 chronic inflammatory demyelinating polyneu- management of tumours 378 ropathy (CIDP) 281 medical 378 clonus 29 radiotherapy 379 357 raised 368 cochlear division 25, 303 seizures 368 codeine/dihydrocodeine 436 sites 369 cognitive function 38, 387 surgical 378 cognitive testing 391 Broca’s area 51 colloid cyst 376 Brown-Sequard syndrome 56 colour vision 291 Brudzinski’s sign 39, 127 coma 213 342 assessment 213 causes 215 C emergency treatment 221 café-au-lait spots 400 general examination 216 caloric testing 226 history 215 carbamazepine 91 investigations 220 care in 431 level of consciousness (LOC) 216 carotid artery stenosis 107 management 220 carotid doppler 109 pathophysiology 213 carpal tunnel syndrome 261 common peroneal nerve 262 case fatality ratio 68 complex partial seizures 79 cauda equina 55 confusion/delirium 195, 225, 437 cerebellar ataxias 404 chlorpromazine 437 54 cerebellum 47, haloperidol 437 51 cerebral hemispheres 47, consciousness 37 cerebral malaria 161 consensual reflex 21, 288 artemether 164 constipation 441 artemisinin compounds 164 coordination 32 artesunate 164 corneal reflex 24, 300 clinical features 162 corticobasal degeneration (CBD) 334 coma 162 corticospinal tracts 55 complications 164 cover test 299 definition 161 cranial nerve disorders 287 diagnosis 163 cranial nerve examination 16 epidemiology 161 assessing the pupils 20 pathophysiology 161 distinguishing the type of deafness 26 Plasmodium falciparum 161 examining eye movements 21 quinine 165 examining the 28 retinopathy 162 examining visual fields 18 seizures 162 fundoscopy 19 treatment 164 head turning 27 cerebral toxoplasmosis 123 jaw opening, closure 24 See . pupillary reactions 20 cervical spondylosis 237 shoulder elevation 27 Charcot-Marie-Tooth disease 405 testing facial movements 25 Charcot’s joints 148 testing facial sensation 23 cholinesterase inhibitors 321 testing hearing 25 406 339, testing smell 17

William Howlett Neurology in Africa 445 Index d – E

testing the gag reflex 27 vascular 389 testing visual acuity 17 dementia with Lewy bodies 334, 386 the accommodation reflex 21 Denis three column model 422 the consensual reflex 21 dermatomes 58 the light reflex 21 dermatomyositis 316 craniopharyngioma 375 Devic’s disease (neuromyelitis optica) 244 cryptococcal meningitis 123, 136, 193 diabetes 277 amphotericin B 138 diffuse axonal injury (DAI) 415 clinical findings 136 diplopia 21, 296 CM and ART 138 disability 70 cryptococcal antigen (CRAg) 137 disability-adjusted life years (DALYs) 69 Cryptococcus neoformans 136 disease burden 69 diagnosis 136 disease prevention 71 fluconazole 137 disorders of peripheral nerves 259 flucytosine 138 distal sensory neuropathy (DSN) 203, 267 prognosis 138 dizziness 304 treatment 137 Doll’s eyes 225 CSF findings in meningitis 129 dopamine 331 cutaneous fibromas 400 dorsal columns 49, 55 cysticercosis 175 drug induced 334 albendazole 176 Duchenne’s muscular dystrophy 314 clinical features 176 dysarthria 52 diagnosis 176 dysdiadochokinesia 32 life cycle 175 dysphagia 438 176 dysphasia 52 praziquantel 176 expressive 53 prevention 178 global 54 seizures 176 receptive 53 steroids 177 dysphonia 52 Taenia solium 174 dyspnoea 440 treatment 176 338 Cytomegalovirus (CMV) 198 E D echinococcosis. See hydatid disease deafness 25, 303 electroencephalography (EEG) 86 dementia 200, 385 electromyography (EMG) 266 aetiology 386 139 Alzheimer’s disease 386 214 cognitive testing 391 79 dementia with Lewy bodies 386 AEDs and women 93 epidemiology 385 aetiology 80 386 brain imaging 88 general course and prognosis 386 clinical diagnosis 84 HIV-associated dementia (HAD) 200, 390 common forms of seizures 81 management 388 discontinuing of AEDs 92 mini mental state examination 392 driving and epilepsy 95 Parkinson’s disease 386 drug treatment 90 prognosis 386 epidemiology 80 risk factors 386 epilepsy syndromes 79

446 Index F – H Index

investigations 86 G management 89 gag reflex 27, 305 prognosis 94 gait disorder 61 93 cerebellar 61 treatment gap 95 hemiparetic 61 Epley’s manoeuvre 305 myopathic 61 ergotamine 355 neuropathic 61 examination of the gait 36 Parkinson’s 61 examination of the limbs 28 sensory ataxic 61 coordination 32 spastic 61 finger nose test 32 generalized tonic-clonic 81 heel shin test 32 general paralysis insane (GPI) 148 inspection 28 Gilles de la Tourette syndrome 340 power 29 Glasgow Coma Scale (GCS) 38, 216 reflexes 33 Glasgow Outcome Scale 417 sensation 34 glioma 370 tone 28 clinical features 370 extradural haematoma 418 management 370 extrapyramidal disorder 330 prognosis 370 Parkinsonism 334 global burden 67 Parkinson plus syndromes 334 glossopharyngeal 26 Parkinson’s disease 329 glossopharyngeal nerve 26, 305 eye movements 21, 295 Gower’s sign 314 tracking 295 grand mal 79 voluntary saccades 295 graphanaesthesia 60 grasp reflex 40 F Guillain-Barre Syndrome (GBS) 205, 279 301 facial nerve 24, clinical features 279 facial pain 360 general management 280 facioscapulohumeral dystrophy 315 intravenous immunoglobulin 280 28 investigations 279 fatigability 319 plasma exchange 280 febrile convulsions 84 prognosis 280 femoral neuropathy 263 finger-nose test 32 H flaccid paraplegia 55 haemorrhage/haematoma 102, 108, 414 fluorosis 238 aneurysm 102 foot drop 262 arteriovenous malformations 102 fourth nerve palsy 298 extradural 418 freckling 400 intracerebral 102, 421 Friedreich’s ataxia 404 subarachnoid 109 Froin syndrome 236 subdural 108, 420 frontal lobe 51, 369 Hallpike’s test 304 frontal lobe release signs (FLRSs) 40, 201 HAT. See human African trypanosomiasis grasp reflex 40 headache 351 palmomental reflex 40, 202 primary 352 snout reflex 40, 201 secondary 357 frontotemporal dementia 389 head injury 413 fundoscopy 19, 293 health delivery 72

William Howlett Neurology in Africa 447 Index I – I

primary care 73 Human T cell lymphotropic virus type 1 (HTLV-1) secondary care 73 244 tertiary care 73 Huntington’s disease (HD) 339, 405 health promotion 71 hydatid disease 182 hearing 25, 303 albendazole 183 Rinne’s test 26, 303 clinical features 182 Weber’s test 26, 303 diagnosis 183 heel shin test 32 Echinococcus granulosus 182 helminthic infections 161 life cycle 182 339 praziquantel 183 hemiparesis 59 prevention 184 hereditary spastic paraparesis (HSP) 406 treatment 183 herpes encephalitis 140 hyperventilation syncope 223 diagnosis 141 28, 305 hiccups 340 hypoglycaemia 224 history taking 13 I HIV. See Human Immunodeficiency Virus HIV-associated dementia (HAD) 200, 390 immobility 440 HIV infection 191 immune reconstitution inflammatory syndrome HIV related neurological illnesses 191 (IRIS) 199 HIV related neuropathy 203, 267 immunoglobulin 322 ART associated neuropathy 204 impaired communication 436 Bell’s palsy 268 incidence rate 67 distal sensory neuropathy (DSN) 203, 267 inclusion body myositis 318 137 inflammatory neuropathies 205, 269 India ink , 193 Holmes Adie pupil 290 infections 123 Horner’s syndrome 289 bacterial 123 Human African Trypanosomiasis (HAT) fungal 123 161, 168 parasitic 123 clinical features 169 protozoa 123 CSF examination 172 viral 123 diagnosis 171 inflammatory myopathies 316 eflornithine 173 inherited myopathies 312 399 encephalitic stage 170, 171 inherited neurological disorders 312, haemolymphatic stage 170 dystrophies 312 life cycle for trypanosomiasis 170 Friedreich’s ataxia 404 melarsoprol (Mel B) 173 Huntington’s disease (HD) 405 nifurtimox 173 neurofibromatosis type 1 399 pentamidine 173 neurofibromatosis type 2 402 prevention 174 neuropathies 405 primary chancre 169 spastic paraparesis 406 prognosis 174 Sturge Weber syndrome 403 suramin 173 tuberous sclerosis 403 treatment 173 Wilson’s disease 407 Trypanosoma brucei gambiense (T.b.g.) 169 inherited neuropathies 405 Trypanosoma brucei rhodesiense (T.b.r.) 168 32 Trypanosomiasis test (CATT) 172 intracerebral haematoma 421 Winterbottom’s sign 170 intracranial pressure 368 Human Immunodeficiency Virus 70, 123 intracranial tumours (ICT) 367

448 Index J – M Index

benign 367 skin 271 malignant 367 slit skin smears 273 intravenous immunoglobulin 280, 322 thalidomide 275 involuntary movements 336 transmission 269 ischaemia 102 treatment 274 Ishihara plates 17 tuberculoid (TT) 269 type 1 reversal reactions 274 J type 2 erythema nodosum leprosum (ENL) Jarish-Herxheimer reaction 149 274 300 jaw jerk 23, levodopa (L-dopa) 331 JC virus 197 light reflex 21, 288 joint position sense 35 afferent pupil defect 288 K efferent pupil defect 288 Kayser-Fleisher ring 407 limb girdle muscular dystrophy 315 Kernig’s sign 39, 127 Lisch nodules 400 konzo 246 localization 47 aetiology 246 locked-in syndrome 219 clinical features 246 loss of posture 330 cyanide 246 lower motor neurone lesion (LMNL) 48 diagnosis 247 lumbar puncture 151 prevention 248 M spastic paraplegia 246 malaria. See cerebral malaria treatment 248 mandibular V3 300 L motor involvement 300 lathyrism 248 mannitol 417 beta-N-oxalylamino-L-alanine (BOAA) 248 maxillary V2 300 grass pea (Lathyrus sativus) 248 measurement of disease 67 paraplegia 248 median nerve 261 Leber’s optic neuropathy 294 medical history 15 leprosy 269 Meige syndrome 338 anaesthetic skin lesions 269 memory 52, 385 biopsy 273 Ménière’s disease 304 borderline 270 meningioma 371 clinical features 269 clinical features 371 clofazimine 274 diagnosis & management 371 complications 275 meningitis 124, 193 dapsone 274 mental state 38 diagnosis 273 meralgia paraesthetica 262 eyes 273 metastases 374 host response 269 differential diagnosis 374 lepromatous (LL) 269 investigations 375 multiple drug treatment (MDT) 274 management 375 Mycobacterium leprae 269 353 nerve enlargement 272 Mini Mental State Examination 392 neurological findings 272 miosis 290 peripheral neuropathy 269 mononeuritis multiplex 260 prevention 276 mononeuropathies 57, 260 rifampicin 274 common peroneal nerve 262

William Howlett Neurology in Africa 449 Index n – N

lateral cutaneous nerve 262 Neisseria meningitidis 125 median nerve 261 nerve conduction studies 266 meralgia paraesthetica 262 neurocysticercosis 174 pathophysiology 259 neurodegenerative disorder 329, 389 Phalen’s sign 261 neurofibromatosis type 1 399 radial nerve 262 neurofibromatosis type 2 402 sciatic nerve 262 neuroleptic malignant syndrome 335 Tinel’s sign 261 neurological disorders in HIV 136, 167, 191 ulnar nerve 262 acute bacterial meningitis (ABM) 193 morphine 436 Bell’s palsy 204 mortality rate 68 confusion and coma 195 motor 23 Cryptococcal meningitis (CM) 136, 193 motor neurone disease (MND) 341 cytomegalovirus (CMV) 198 clinical subtypes 341 distal sensory neuropathy (DSN) 203 diagnosis 343 focal neurological disorder (FND) 191 investigations 343 Guillain-Barre Syndrome (GBS) 205 management 343 Herpes zoster 191 motor seizures (Jacksonian epilepsy) 84 HIV-associated dementia (HAD) 200 motor system 47 HIV-associated neurocognitive dysfunction movement disorders 329 (HAND) 200 (MSA) 334 immune reconstitution inflammatory syn- muscle disorders 311 drome 199 acquired myopathies 311 lymphoma 194 dystrophies 312 meningitis 191 other myopathies 318 myopathy 191 muscular dystrophy 311 palmomental reflex 201 myasthenia gravis 318 paraparesis 202 cholinesterase inhibitors 321 polymyositis 204 complications 319 progressive multifocal leucoencephalopathy diagnosis 320 (PML) 197 differential diagnosis 319 retinopathy 199 immunosuppression 321 seizures 196 management 321 snout reflex 201 pyridostigmine 321 stroke 195 signs 319 TB meningitis (TBM) 193 symptoms 319 toxoplasma encephalitis (TE) 166, 194 339 tuberculoma 194 myopathies 311 vacuolar (VM) 191, 202 clinical history 311 varicella-zoster 197 electromyography 312 neurological examination 16 inflammatory myopathies 316 neurological infections 123 investigations 312 neuromuscular junction 60 physical examination 311 neuromyelitis optica. See Devic’s disease myopathy 205, 311 neuropathy. See peripheral neuropathies myotonic dystrophy 313 neurosyphilis 147 non-opioids 434 N non traumatic paraplegia. See paraplegia nausea and vomiting 439 nystagmus 299 neck stiffness 127

450 Index O – P Index

O causes 329 occipital lobe 369 clinical diagnosis 330 occupational therapists 251 course 333 ocular myasthenia gravis 319 gait 54, 330 oculocephalic reflex 225 levodopa (L-dopa) 331 oculomotor nerve 21, 295 other drug treatments 332 oculovestibular reflex 226 pathophysiology 329 olfactory nerve 16, 287 rigidity 54, 330 ophthalmic V1 300 treatment 331 opioids 434 tremor 54, 330 opisthotonos 146 patterns of motor loss 59 optic atrophy 294 patterns of sensory loss 59 optic nerve 17, 287 peripheral nerve disorders 50 optic neuritis 293 peripheral 57 Devic’s disease 294 peripheral neuropathies 203, 259 orientation 37 persistent vegetative state 219 pethidine 436 P petit mal 79 432 pain 351, phenytoin 91 adjuvants 435 Pick’s disease 389 causes 433 pinealoma 377 drug treatment 434 pituitary tumours 373 management 433 clinical features 373 measurement 433 diagnosis 373 neuropathic 432 management 374 nociceptive 432 plasma exchange 322 non-opioids 434 plexiform neuromas 400 opioids 435 polymyositis 311, 316 pathophysiology 432 polyneuropathies 263 WHO analgesic ladder 436 causes 264 441 clinical features 264 aims 442 diagnosis 266 general care and support 441 electromyography 266 needs 441 investigations 266 relieve pain & other symptoms 442 management 266 202 palmomental reflex 40, motor 264 293 papilloedema 20, sensory 265 231 paraplegia 55, Pott’s disease 233 paraplegia non traumatic 231 clinical features 233 aetiology 231 investigations 233 compressive causes 233 prognosis 234 management 249 treatment 234 non compressive causes 240 power 30 tropical myeloneuropathies 246 presenting complaint 14 369 parietal lobe 49, prevalence rate/ratio 68 Parkinsonism 334 primary CNS lymphoma 376 Parkinson plus syndromes 334 primary lateral sclerosis (PLS) 343 329 Parkinson’s disease 54, progressive bulbar/pseudobulbarpalsy (PBP/PSP) bradykinesia 54, 330 342

William Howlett Neurology in Africa 451 Index Q – S progressive multifocal leucoencephalopathy treatment 181 (PML) 197 schwannoma 377, 402 progressive muscular atrophy (PMA) 342 sciatic nerve 262 progressive supranuclear palsy (PSP) 334 secondary 357 protozoal infections 161 seizures 79 pseudoseizures 85, 224 seizure types psychogenic coma 219 absence 82 67, 79 febrile convulsions 84 pupillary disorders 289 generalized tonic-clonic 81 pupillary reactions 20 motor seizures (Jacksonian) 84 pupillary responses 287 myoclonic 83 partial onset 83 Q temporal lobe 83 quadriplegia 56 sensory level 55 R sensory testing 35 Rabies 141 signs of meningism 39 clinical features 142 Brudzinski’s sign 39 laboratory diagnosis 143 Kernig’s sign 39 pathogenesis 142 neck stiffness 39 prevention 144 sixth nerve palsy 298 treatment 144 sleeping sickness. See HAT vaccination 144 smell 16, 287 radial nerve 262 Snellen chart 17, 291 Ramsay-Hunt syndrome 301 snout reflex 40, 201 reflexes 33 sodium valproate 92 rest tremor 330 spasticity 439 retinopathy 198, 293 spastic paraplegia 55, 246 rigidity 330 speech disorders 52 Rinne’s test 26, 303 47 risus sardonicus 145 corticospinal tract 47 Romberg’s test 37 dorsal columns 49 spinothalamic tracts 49 S spinal cord tuberculosis 233 schistosomiasis 178, 242 spinal cord tumours 235 clinical features 180 spinal injury 422 diagnosis 181 spinocerebellar disorders 404 epidemiology 178 squint 298 life cycle 178 states of altered consciousness 225 paraparesis 180 status epilepticus 93 paraplegia 242 drug treatment 94 pathogenesis 179 management 94 praziquantel 181 sternomastoid muscle 305 prevention 181 straight leg raising test 40 prognosis 181 stroke 101, 195 Schistosoma haematobium 178 aetiology 102 Schistosoma japonicum 178 anticoagulation 112 Schistosoma mansoni 178 antiplatelet drugs 112 seizures 180 blood pressure 112 steroids 181 clinical presentation 104

452 Index T – T Index

complications 113 Clostridium tetani 145 definition 101 diagnosis 146 differential diagnosis 108 management 146 epidemiology 101 pathogenesis 145 investigations 108 prevention 146 localization 104 thalamus 49 management 111 third nerve palsy 296 pathogenesis 102 thymectomy 322 prevention 115 tics 340 prognosis 116 Tinel’s sign 261 rehabilitation 114 tinnitus 305 thrombolysis 113 Todd’s paralysis 84, 108 vascular risk factors 103 tone 28 Sturge Weber syndrome 403 touch sensation 34 sub acute combined degeneration of the cord toxoplasmosis 161, 166 (SACD) 245, 278 clinical presentation 166 subarachnoid haemorrhage (SAH) 109 diagnosis 166 clinical presentation 109 differential diagnosis 167 investigations 110 focal neurological signs 166 management 110 prognosis 168 neurosurgical 110 Toxoplasma gondii 166 prognosis 111 treatment 167 subdural haematoma 420 trimethoprim/sulphamethoxazole (TMP- superficial reflexes 40 SMX) 167 abdominal reflex 40 tramadol 436 cremasteric reflex 40 transient ischaemic attack (TIA) 105, 224 swinging torch test 289 transient loss of consciousness 105, 213, 222 Sydenham’s chorea 339 cardiac syncope 222 syncope 222 cerebrovascular syncope 223 syphilis 147, 243 hyperventilation syncope 223 general paralysis insane (GPI) 148 hypoglycaemia 224 meningitis 148 postural syncope 223 meningovascular syphilis 148 pseudoseizures 224 tabes dorsalis (TD) 148 syncope and seizures 223 syringomyelia 239 transient ischaemic attack (TIA) 105, 224 vasovagal syncope (faint) 222 T transverse (TM) 241 tabes dorsalis 148 clinical features 241 Taenia solium 174 prognosis 241 temperature sensation 35 treatment 241 temporal arteritis 359 traumatic brain injury 413 369 temporal lobe 52, causes 413 temporal lobe epilepsy 83 classification 415 tendon reflexes 33 clinical diagnosis 414 tensilon test 320 epidemiology 413 352 evaluation 416 management 353 imaging 414 145 tetanus 123, management 416 clinical features 145 outcome 417

William Howlett Neurology in Africa 453 Index U – X

pathology 413 Epstein-Barr virus 139 rehabilitation 418 Herpes simplex 139 tremor 336 HIV 139 trigeminal nerve 23, 300 management 141 motor 23 rabies 139 sensation 23 viral meningitis 139 trigeminal neuralgia (TN) 360 clinical features 139 triptans 354 visual acuity 17, 291 trochlear nerve 21, 295 Snellen chart 291 tropical ataxic neuropathy (TAN) 249 visual fields 18, 292 tropical myeloneuropathies 246 bitemporal hemianopia 292 Trypanosoma brucei gambiense (T.b.g.) 169 homonymous hemianopia 292 Trypanosoma brucei rhodesiense (T.b.r.) 168 monocular 292 trypanosomiasis. See Human African Trypanoso- vitamin B-1 deficiency 278 miasis (HAT) vitamin B-6 deficiency 278 tuberculous meningitis (TBM) 123, 131, 193 vitamin B-12 deficiency 245, 278 clinical features 131 vomiting 439 CSF 129 W diagnosis 133 management 134 wasting 28 outcome 135 Waterhouse-Frederickson syndrome 128 303 pathogenesis 131 Weber’s test 26, prevention 135 Wernicke-Korsakoff-syndrome 278 TBM in HIV 135, 193 Wernicke’s area 53 treatment 135 WHO analgesic ladder 436 tuberous sclerosis 403 Wilson’s disease 407 facial angiofibromata 403 winging of scapulae 315 hamartoma 403 wrist drop 262 tumour brain 367 writer’s cramp 338 tumour spinal cord 235 X U xanthochromia 110, 153 ulnar nerve 262 X-linked dystrophin 312 upper motor neurone lesion (UMNL) 47 V vacuolar myelopathy 202 26, 305 Varicella-zoster 197 389 vascular parkinsonism 334 vasovagal syncope (faint) 222 ventilation 322 vertigo/dizziness 304 vestibular division 25, 303 vibration sense 35 139 clinical findings 140 Names of main infecting organisms in italics Cytomegalovirus (CMV) 139 Page number in bold face indicates major discussion

454 Index ABBREVIATIONS

Dr William P. Howlett 2012 ABBREVIATIONS ABM acute bacterial meningitis CV conduction velocity AC air conduction CVS cardiovascular system ACA anterior cerebral artery CXR chest X-ray AChR acetylcholine receptor DA dopamine AD Alzheimer’s disease DAI diffuse axonal injury ADC AIDS dementia complex DALYs disability adjusted lost years ADEM acute disseminated encephalomyelitis d4T stavudine ADL activities of daily living ddi didanosine AED antiepileptic drug DHE dihydroergotamine AF atrial fibrillation DLB dementia with Lewy bodies AIDP acute inflammatory demyelinating DM diabetes mellitus polyneuropathy DMD Duchenne muscular dystrophy AIDS acquired immune deficiency syndrome DOT directly observed treatment ALS amyotrophic lateral sclerosis DSN distal sensory neuropathy ART antiretroviral DVT deep vein thrombosis AVM arteriovenous malformation EBV Epstein-Barr virus AZT zidovudine ECG electrocardiogram BB borderline leprosy EDH extradural haematoma BC bone conduction EEG electroencephalogram BET benign EMG electromyography bd twice daily ENL erythema nodosum leprosum BIH benign intracranial hypertension ESR erythrocyte sedimentation rate BMD Becker muscular dystrophy FBC full blood count BP blood pressure FC febrile convulsion BPPV benign paroxysmal positional vertigo FH family history BTL borderline tuberculoid leprosy FLRSs frontal lobe release signs CATT card agglutination trypanosomiasis test FND focal neurological disorder/deficit CBD corticobasal degeneration FSH facioscapulohumeral dystrophy CDH chronic daily headache FTP frontotemporal dementia CFR case fatality ratio/rate FTA fluorescent treponemal antibody CIDP chronic inflammatory demyelinating absorption (FTA) polyneuropathy FVC forced vital capacity CM cryptococcal meningitis GABA gamma-aminobutyric acid CMTD Charcot–Marie-Tooth disease GBS Guillain-Barre syndrome CMV cytomegalovirus GCS Glasgow Coma Scale CNS central nervous system GTCS generalized tonic clonic seizure COW circle of Willis HAART highly active antiretroviral therapy CPA cerebellopontine angle HAD HIV associated dementia CR controlled release HAM HTLV associated myelopathy CRAg cryptococcal antigen HAND HIV associated neurocognitive CSF dysfunction CT computerized tomography HAT human African trypanosomiasis CTS carpal tunnel syndrome Hb haemoglobin

456 Abbreviations HCW health care worker MRI magnetic resonance imaging HD Huntington’s disease MSA multiple system atrophy HI head injury MUP motor unit potential Hib haemophilus influenza NAP nerve action potential HIV human immunodeficiency virus NCD non communicable disease HMSN hereditary motor sensory neuropathy NCS nerve conduction study HSE herpes simplex encephalitis NF1 neurofibromatosis type 1 HSP hereditary spastic paraparesis NF2 neurofibromatosis type 2 HSV herpes simplex virus NGT nasogastric tube HTLV-1 human T-cell lymphotropic virus type 1 NMJ neuromuscular junction IBM inclusion body myositis NMO neuromyelitis optica IAC internal auditory canal NSAID non-steroidal anti-inflammatory drug ICA internal carotid artery NTP non traumatic paraplegia ICH intracerebral haemorrhage od once daily ICP intracranial pressure OI opportunistic infection ICT intracranial tumour ON optic neuritis ICU intensive care unit OP opening pressure IFA immunofluorescent antibody OT occupational therapist IVIG intravenous immunoglobulin PBP progressive bulbar palsy im intramuscular PCL primary cerebral lymphoma INO internuclear opthalmoplegia PC posterior column INR international normalized ratio PCA posterior cerebral artery IPD idiopathic Parkinson’s disease PCP pneumocystis IRIS immune reconstitution inflammatory PCR polymerase chain reaction syndrome PD Parkinson’s disease iv intravenous PE plasma exchange JME juvenile PHB phenobarbitone LCST lateral corticospinal tract PHCW primary health care worker LFT liver function test PHT phenytoin LGMD limb girdle muscular dystrophy PLS primary lateral sclerosis LMNL lower motor neurone lesion PM polymyositis LOC loss of consciousness PMA progressive muscular atrophy LL lepromatous leprosy PMH past medical history LP lumbar puncture PML progressive multifocal MAOI monoamine oxidase inhibitors leucoencephalopathy MAP muscle action potential PND peripheral nerve disorder MCA middle cerebral artery PNS peripheral nervous system MD myotonic dystrophy po per oral MDT multidrug therapy PP paraplegia MG myasthenia gravis PSP progressive supranuclear palsy MMSE mini mental state examination qds four times a day MND motor neurone disease RAPD relative afferent pupil defect MR mortality rate RDT rapid diagnostic test MRC Medical Research Council RRT rapid reagent test

William Howlett Neurology in Africa 457 RTA road traffic accident Rx treatment SACD subacute combined degeneration of spinal cord SAH subarachnoid haemorrhage sc subcutaneous SDH subdural haematoma SNAP sensory nerve action potential SOL space occupying lesion SSA sub Saharan Africa STT spinothalamic tract SUDEP sudden unexpected death in epilepsy SVP sodium valproate TA temporal arteritis TAN tropical ataxic neuropathy TB tuberculosis Tbg Trypanasoma brucei gambiense TBI traumatic brain injury TBM tuberculous meningitis Tbr Trypanasoma brucei rhodesiense tds three times daily TE toxoplasma encephalitis TIA transient ischaemic attack TLE temporal lobe epilepsy TN trigeminal neuralgia TPHA Treponema pallidum haemagglutination assay TPI treponemal pallidum immobilization test TT tuberculoid leprosy U&E urea and electrolytes UMNL upper motor neurone lesion VA visual acuity VDRL Venereal Disease Research Laboratory VM vacuolar myelopathy ZN Ziehl-Neelsen VZ varicella zoster WHO World Health Organization WKS Wernicke-Korsakoff-syndrome YLD years lived with disability YLL years life lost

458 Abbreviations USEFUL WEBSITES

Dr William P. Howlett 2012 USEFUL WEBSITES

General Medical Websites 1. www.healthnet.org/essential-links Highly systematic listing of health care websites aimed at professionals in the developing world. 2. www.pubmedcentral.nih.gov “Large number of full-text biomedical journals available at publication date or after six months or one year.” John Eyers. 3. extranet.who.int/hinari/en/journals.php A highly useful resource for researchers; medical students may require initial formal instruction. 4. www.unaids.com Useful resource covering both the socio-economic and medical aspects of HIV/AIDS. 5. www.cdc.gov High yield resource for infectious disease; rapid response to on-line queries.

Neurology Websites 1. emedicine.medscape.com/neurology Excellent link to neurology articles on a wide range of topics. Detailed yet concise information. 2. hardinmd.lib.uiowa.edu/neuro.html Contains links to neurology websites chosen for quality; useful resource. 3. www.freebooks4doctors.com/fb/NEURO.HTM Free downloads of various high quality neurology texts; excellent resource. 4. www.freemedicaljournals.com/fmj/IP_NEURO.HTM Free access to world-renowned neurology journals such as “Brain” and “Archives of Neurology”. 5. www.neuroexam.com/neuroexam Videos on neurologic exam from Yale New Haven Hospital; excellent website. 6. www.med.harvard.edu/AANLIB/home.html Very useful resource; serves as an introduction to neuro-imaging for medical students. 7. www.who.int/topics/meningitis/en Simple but relevant information on bacterial meningitis; fact sheet is a must read for students. 8. www.refbooks.msf.org/MSF_Docs/En/Meningitis/Mening_en.pdf Useful resource on case detection and management of epidemic meningococcal meningitis. 9. www.ilep.org.uk Very useful for introducing leprosy diagnosis and treatment. 10. www.epilepsy.org.uk Useful for introduction to epilepsy; med students may need additional information.

460 useful websites