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Topical Diagnosis in Neurology

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Topical Diagnosis in Neurology V Preface In 2005 we publishedacomplete revision of Duus’ Although the book will be useful to advanced textbook of topical diagnosis in neurology,the first students, also physicians or neurobiologists inter- newedition since the death of its original author, estedinenriching their knowledge of neu- Professor PeterDuus, in 1994.Feedbackfromread- roanatomywith basic information in neurology,oR ers wasextremelypositive and the book wastrans- for revision of the basics of neuroanatomywill lated intonumerous languages, proving that the benefit even morefromit. conceptofthis book wasasuccessful one: combin- This book does notpretend to be atextbook of ing an integrated presentation of basic neu- clinical neurology.That would go beyond the scope roanatomywith the subject of neurological syn- of the book and also contradict the basic concept dromes, including modern imaging techniques. In described above.Firstand foremostwewant to de- this regard we thank our neuroradiology col- monstratehow,onthe basis of theoretical ana- leagues, and especiallyDr. Kueker,for providing us tomical knowledge and agood neurological exami- with images of very high quality. nation, it is possible to localize alesion in the In this fifthedition of “Duus,” we have preserved nervous system and come to adecision on further the remarkablyeffective didactic conceptofthe diagnostic steps. The cause of alesion is initially book,whichparticularly meets the needs of medi- irrelevant for the primarytopical diagnosis, and cal students. Modern medical curricula requirein- elucidation of the etiology takes place in asecond tegrative knowledge,and medical studentsshould stage. Our book contains acursoryoverviewofthe be taught howtoapplytheoretical knowledge in a major neurologicaldisorders, and it is notintended clinical settingand, on the other hand, to recognize to replace the systematic and comprehensive clinical symptoms by delving intotheir basic coverage offeredbystandardneurological text- knowledge of neuroanatomyand neurophysiology. books. Our book fulfils these requirementsand illustrates We hope that this new“Duus,” likethe earlier the importance of basic neuroanatomical knowl- editions, will merit the appreciation of its edge for subsequent practical work,asitincludes audience, and we look forward to receiving read- actual case studies. We have color-codedthe sec- ers’ commentsinany form. tion headings to enable readers to distinguish at a glance between neuroanatomical (blue) and clini- cal (green) material, without disrupting the the- Professor M. Baehr matic continuity of the text. Professor M. Frotscher aus: Baehr, Topical Diagnosis in Neurology (ISBN 9783136128053) © 2012 Georg Thieme Verlag KG VI ·Preface Contents 1 Elements of the Nervous System ............................................. 2 Information Flow in the Nervous System . 2 Functional Groups of Neurons ............ 7 Neurons and Synapses .................... 2 Glial Cells ................................ 7 Neurons .................................. 2 Development of the Nervous System ...... 8 Synapses ................................. 4 Neurotransmitters and Receptors ......... 7 2 Somatosensory System ......................................................... 12 Peripheral Components of the Somato- Posterior Columns ......................... 28 sensory System and Peripheral Regulatory Anterior Spinothalamic Tract .............. 30 Circuits .................................. 12 Lateral Spinothalamic Tract ................ 30 Receptor Organs .......................... 12 Other Afferent Tracts of the Spinal Cord .... 31 Peripheral Nerve, Dorsal Root Ganglion, Central Processing of Somatosensory Posterior Root ............................. 14 Information .............................. 32 Peripheral Regulatory Circuits .............. 18 Somatosensory Deficits due to Lesions at Central Components of the Somato- Specific Sites along the Somatosensory sensory System ........................... 24 Pathways ................................. 32 Posterior and Anterior Spinocerebellar Tracts .................................... 25 3 Motor System .................................................................... 36 Central Components of the Motor System Complex Clinical Syndromes due to and Clinical Syndromes of Lesions Affect- Lesions of Specific Components of the ing Them ................................. 36 Nervous System .......................... 45 Motor Cortical Areas ...................... 36 Spinal Cord Syndromes .................... 45 Corticospinal Tract (Pyramidal Tract) ....... 38 Vascular Spinal Cord Syndromes ........... 56 Corticonuclear (Corticobulbar) Tract ........ 39 Nerve Root Syndromes (Radicular Other Central Components of the Motor Syndromes) ............................... 57 System ................................... 39 Plexus Syndromes ......................... 62 Lesions of Central Motor Pathways ......... 41 Peripheral Nerve Syndromes ............... 67 Syndromes of the Neuromuscular Junction Peripheral Components of the Motor and Muscle ............................... 72 System and Clinical Syndromes of Lesions Affecting Them ........................... 43 Clinical Syndromes of Motor Unit Lesions ... 44 aus: Baehr, Topical Diagnosis in Neurology (ISBN 9783136128053) © 2012 Georg Thieme Verlag KG Contents · VII 4 Brainstem ......................................................................... 74 Surface Anatomy of the Brainstem ........ 74 Vestibulocochlear Nerve (CN VIII)—Cochlear Medulla .................................. 74 Component and the Organ of Hearing ...... 113 Pons ...................................... 75 Vestibulocochlear Nerve (CN VIII)— Midbrain ................................. 75 Vestibular Component and Vestibular System ................................... 120 Cranial Nerves ............................ 77 Vagal System (CN IX, X, and the Cranial Origin, Components, and Functions ......... 77 Portion of XI) ............................. 126 Olfactory System (CN I) .................... 81 Hypoglossal Nerve (CN XII) ................ 132 Visual System (CN II) ...................... 84 Eye Movements (CN III, IV, and VI) ......... 89 Topographical Anatomy of the Brainstem . 134 Trigeminal Nerve (CN V) ................... 103 Internal Structure of the Brainstem ......... 134 Facial Nerve (CN VII) and Nervus Brainstem Disorders ...................... 145 Intermedius ............................... 109 Ischemic Brainstem Syndromes ............ 145 5 Cerebellum ....................................................................... 158 Surface Anatomy ......................... 158 Cerebellar Function and Cerebellar Syndromes ............................... 164 Internal Structure ........................ 159 Vestibulocerebellum ....................... 164 Cerebellar Cortex .......................... 159 Spinocerebellum .......................... 165 Cerebellar Nuclei .......................... 160 Cerebrocerebellum ........................ 166 Afferent and Efferent Projections of the Cerebellar Cortex and Nuclei ............... 162 Cerebellar Disorders ...................... 167 Cerebellar Ischemia and Hemorrhage ....... 167 Connections of the Cerebellum with Cerebellar Tumors ......................... 167 Other Parts of the Nervous System ........ 162 6 Diencephalon and Autonomic Nervous System ........................... 170 Location and Components of the Hypothalamus ............................ 178 Diencephalon ............................ 170 Location and Components ................. 178 Hypothalamic Nuclei ...................... 179 Thalamus ................................ 172 Afferent and Efferent Projections of the Nuclei .................................... 172 Hypothalamus ............................ 180 Position of the Thalamic Nuclei in Functions of the Hypothalamus ............ 184 Ascending and Descending Pathways ....... 172 Functions of the Thalamus ................. 176 Peripheral Autonomic Nervous System ... 188 Syndromes of Thalamic Lesions ............ 176 Fundamentals ............................. 188 Thalamic Vascular Syndromes .............. 177 Sympathetic Nervous System .............. 190 Parasympathetic Nervous System .......... 192 Epithalamus .............................. 177 Autonomic Innervation and Functional Subthalamus ............................. 178 Disturbances of Individual Organs .......... 193 Visceral and Referred Pain ................. 199 aus: Baehr, Topical Diagnosis in Neurology (ISBN 9783136128053) © 2012 Georg Thieme Verlag KG VIII ·Contents 7 Limbic System .................................................................... 202 Anatomical Overview ..................... 202 Functions of the Limbic System ........... 206 Internal and External Connections .......... 203 Types of Memory ......................... 206 Memory Dysfunction—the Amnestic Major Components of the Limbic System . 203 Syndrome and Its Causes .................. 208 Hippocampus ............................. 203 Microanatomy of the Hippocampal Formation ................................ 203 Amygdala ................................. 205 8 Basal Ganglia ..................................................................... 214 Preliminary Remarks on Terminology .... 214 Function and Dysfunction of the Basal Ganglia ................................... 219 The Role of the Basal Ganglia in the Motor Clinical Syndromes of Basal Ganglia System: Phylogenetic Aspects ............. 214 Lesions ................................... 219 Components of the
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