Index

A Agitated delirium , 1 Abscesses Alcohol fungal , 408 , 409 and dementia , 72 supratentorial masses , 406 withdrawal, seizures , 318 Absence seizures , 311 , 326 Alcohol-related myopathies , 162 Acetazolamide Aldolase, proximal weakness , 156 pseudotumor cerebri , 295 Alleviating factors, headache , 288 vertigo , 146 ALS . See Amyotrophic lateral sclerosis (ALS) Acetylcholine receptor (AChR) binding Alzheimer dementia , 65 antibodies , 163 Alzheimer disease (AD) , 64 , 66–67 , 320 Acetylcholinesterase inhibitors , 205 AMPA receptor , 18 Activities of daily living, parkinsonism , 197 Ampicillin , 14 Acute antiplatelet therapy , 356 Amyloid angiopathy , 368–369 Acute compression fractures , 274 Amyloidosis , 237 Acute confusional state, stroke , 345 Amyloid PET imaging , 65 Acute disseminated encephalomyelitis Amyotrophic lateral sclerosis (ALS) , 168–169 (ADEM) , 383–384 Angle closure glaucoma , 90 Acute infl ammatory demyelinating Anisocoria polyradiculoneuropathy (AIDP) , 187 cavernous sinus lesions , 116 Acute life support , 366 ciliary ganglion lesions , 116–117 Acute occipital-temporal infarction, 351 clinical approach , 117 , 119 Acute fascicular and subarachnoid lesions , 116 botulism , 190 fi rst-order neuron , 118 brainstem catastrophe , 189–190 iris lesions , 117 GBS , 187–188 nuclear lesions , 116 myasthenic crisis , 189 physiologic anisocoria , 119 poliomyelitis , 191 second-order neuron , 118 polyneuropathies , 190–191 third-order neuron , 118 spinal cord insults , 191 Anomic aphasia , 49 Acute post-anoxic myoclonus , 217 Antalgic , 282 Adrenoleukodystrophy (ALD) , 270 Anterior cerebral artery (ACA) syndrome , 339 Adrenomyeloneuropathy (AMN) , 270 Anterior choroidal artery (AChA) , 340 Adult attention defi cit hyperactivity disorder Anterior circulation ischemic strokes (ADHD) , 75 ACA syndrome , 339 Advanced stage treatment, Parkinson disease , 204 ICA , 339–340 Age of onset, parkinsonism , 195 MCA syndrome , 337–339

© Springer International Publishing Switzerland 2016 413 A. Tarulli, Neurology, DOI 10.1007/978-3-319-29632-6 414 Index

Anticoagulation Arteriovenous malformations (AVM) hyperacute ischemic stroke , 357 hemorrhage , 404 after intracerebral hemorrhage , 369–370 ICH , 369 reversing, ICH , 367 MRI , 404–406 heparin , 367 seizures , 320 warfarin , 367 Articulatory errors , 44 stroke , 361–362 Aspiration , 365 Anticonvulsants , 324 , 3–4 Antiemetic agents, status migrainosus , 301 Asymmetric limb weakness , 171 Antiepileptic drugs (AEDs) Asymmetric resting , 196 appropriate duration , 328 Asymptomatic carotid artery stenosis , 364 interactions , 330 , parkinsonism , 196 phenytoin dosing and levels , 325 Ataxic gait , 281 recurrence of seizure , 322 , 220 renal dysfunction , 323 Atonic seizures , 312 seizures , 317 Atrial fi brillation (AF) status epilepticus , 333 anticoagulation , 369 withdrawing , 331–332 stroke , 358–359 Anti-Ma2 , 18 Atypical facial pain , 306 Antiplatelet agents , 363 Atypical parkinsonism Antiplatelet therapy , 362 CBD , 208 Antisaccade test , 61 MSA , 207 Anxiety, multiple sclerosis , 392 PSP , 206–207 Aphasia Atypical symptoms , 377 anomic aphasia , 49 Auditory hallucinations , 313 aphemia , 50 Aura bedside examination , 43–44 headache , 287 Broca aphasia , 46–47 sensory , 311 cause and treatment , 50–51 symptoms , 296 comprehension , 44–45 Autoimmune disorders, epilepsy , 321 conduction aphasia , 48 Autonomic dysfunction, parkinsonism , 196 confrontation naming , 45–46 AVM . See Arteriovenous malformations (AVM) confusion , 50 Axial rigidity , 207 dysarthria , 49–50 Axonal neuropathy , 186 global aphasia , 48 Azathioprine , 159 mixed transcortical aphasia , 48–49 paraphasic errors , 44 reading , 46 B recovery and rehabilitation , 51 B cell type non-Hodgkin lymphomas , 404

repetition , 45 B12 defi ciency , 236 spontaneous speech , 44 Back pain subcortical aphasias , 49 adrenoleukodystrophy , 270 TCMA , 48 cauda equina syndrome , 264 transcortical sensory aphasia , 48–49 copper-defi ciency myelopathy , 271 Wernicke aphasia , 47 dural AVF , 271 writing , 46 epidural abscess , 268 Aphemia , 50 herniated nucleus pulposus , 264–265 Apnea test , 38 HSP , 271 Apparent diffusion coeffi cient (ADC) , infl ammatory radiculopathies , 271–273 350 , 351 MLD , 270 Apraxia multiple sclerosis , 269 defi niton , 58–59 musculoskeletal (see Musculoskeletal eyelid-opening , 207 back pain) Arteriovenous fi stula (AVF) , 271 myelopathy , 262–263 Index 415

neoplasm , 267–268 Bradykinesia , 149 non-neurologic , 273 examination , 198 radiculopathy , 261–262 oropharyngeal , 206 red fl ags , 264 Brain death , 38–39 spinal cord infarction , 269–270 Brainstem catastrophe , 189–190 spinal stenosis , 266–267 Brainstem encephalitis , 106 transverse myelitis , 269 Broca aphasia , 46–47 tropical spastic paraparesis , 270 Brudzinski sign , 12

vitamin B12 defi ciency , 269 Bruns nystagmus , 138 Bacterial meningitis , 12–14 Balint syndrome , 92 Ballismus , 218 C Barbecue spit maneuvers , 143 C5 radiculopathy , 173 , 248 Becker muscular dystrophy (BMD) , 160 C6 radiculopathy , 173 , 250 Behavioral abnormalities , 54 C8 radiculopathy , 175 , 251 Behavioral variant FTD , 67–68 Calcifi cation, gliomas , 403 Bell palsy , 123 Cancer prognosis of , 125 brachial plexopathy , 249 stroke , 348 lumbosacral plexopathy , 257 treatment , 125 Cardiac evaluation , 358–359 Benign familial tremor , 212 Cardiogenic syncope , 134 Benign paroxysmal positional vertigo Carotid artery dissection , 291–292 , 340 (BPPV) , 139 Carotid duplex ultrasound , 359 canal variant , 143 Carotid endarterectomy (CEA) , 362–363 epley particle-repositioning Carotid sinus syncope , 134 maneuvers , 141 Carotid stenosis , 362–363 pathophysiology , 141–142 Carpal tunnel syndrome (CTS) , 252–253 Benzodiazepines , 10 , 21 Carpometacarpal joint , 255 PD , 201 Catechol-o -methyltransferase (COMT) status epilepticus , 332 inhibitor , 203 Bitemporal hemianopsia , 85 , 90 , 292 Cauda equina syndrome , 179 , 264 Bleeding diatheses , 369 Causalgia , 259 Blepharospasm , 114–115 Cavernous sinus lesions , 99 , 101 , 104 , 105 Blink refl ex Central nervous system (CNS) patterns on , 28 demyelinating disorder , 383 schematic of , 27 dysfunction , 168 Blood pressure localizations , 178–179 control , 360 Central retinal artery occlusion , 86 , 89 hyperacute ischemic stroke , 357 Central retinal venous occlusion , 86 treatment , 368 Central scotoma , 85 Blood tests, stroke , 359–360 Cerebellar infarction , 358 Borrelia burgdorferi , 1 6 Cerebellar outfl ow tremor , 215 Botulism Cerebellar signs, vertigo acute paralysis , 190 fi nger-to-nose test , 136 neuromuscular junction disorder , 113 heel–knee–shin test , 137 BPPV . See Benign paroxysmal positional overshoot , 137 vertigo (BPPV) rebound , 137 Brachial plexopathy , 173 , 248 , 137 cancer , 249 Cerebellar stroke syndrome , 343–344 idiopathic brachial neuritis , 249 Cerebellopontine angle (CPA) lower trunk , 251–252 intracranial mass , 407 lumbosacral plexopathy , 256 tumors , 145 radiation-induced , 249 Cerebral achromatopsia , 93 trauma , 248–249 Cerebral vasculature , 353 416 Index

Cerebral venous sinus thrombosis (CVST) , Coma 293–294 absent movements , 33 Cerebral venous thrombosis , 344 brain death , 38–39 Cerebrospinal fl uid (CSF) etiologies and mimics , 36 lumbar puncture , 12 , 381 examination , 34–35 multiple sclerosis , 378 , 381 , 383 , 384 blink refl ex , 27–29 PCNSL , 404 mental status examination , 25 rapidly progressive weakness , 187 pupillary reactions , 26–27 Cerebrovascular disease , 208 , 319 eye position Cervical dystonia (CD) , 222 horizontal , 29–30 Cervical myelopathy , 241 vertical , 30 Cervical spondylosis , 145 history , 25 , 34–35 Cervicogenic dizziness , 145 increased intracranial pressure , 39 Charcot–Marie–Tooth (CMT) disease , 233 , 238 intracranial pressure , 40–41 Charles Bonnet syndrome , 7 medical causes of , 34 Chiari malformation , 138 minimally conscious state , 38 Chlordiazepoxide , 10 motor examination , 32 Chorea MRI, EEG, and lumbar puncture , 35–36 causes of , 221 oculocephalic response , 30–32 gravidarum , 220 prognostication , 37 huntington disease , 220–221 pupillary reactions , 26 Chronic daily headache (CDH) , 302–303 PVS , 37–38 Chronic infl ammatory demyelinating refl ex movements , 32–33 polyradiculoneuropathy (CIDP) , respiratory patterns , 33 166–168 spontaneous Chronic post-anoxic myoclonus , 217 and nonpurposeful , 32 Chronic progressive external ophthalmoplegia and purposeful , 32 (CPEO) , 113–114 eye movements , 30 Chronic traumatic encephalopathy (CTE) , 73 toxins , 36 Chronic undifferentiated dizziness , 145 transtentorial herniation , 40 Circle of Willis , 337 , 338 uncal herniation , 39–40 Cisternal segment lesions , 104 Complex partial seizures (CPS) , 310 , 311 , CJD . See Creutzfeldt–Jakob disease (CJD) 326–327 CK . See Creatine kinase (CK) Complex regional pain syndrome (CRPS) , 259 Clinical isolated syndromes (CIS) Compound muscle action potential diplopia , 376 (CMAP) , 188 disease-modifying treatment , 387 Computed tomographic angiography motor syndromes , 376 (CTA) , 353 multifocal and progressive presentations, 377 RCVS , 292 myelopathy , 375 stroke , 359 optic neuritis , 386–387 Computed tomography (CT) radiologically isolated syndrome , 377 CVST , 293 sensory syndromes , 376 ischemic stroke , 351 treatment , 387 neurocysticercosis , 410 visual loss , 375 non-contrast head , 409 Clopidogrel , 362 primary tumor , 400 Clot retrieval devices, stroke , 356–357 SAH , 290 Clumsy hand-dysarthria , 344 SIH , 300 Cluster headache , 298 stroke , 349–351 Coccidioides immitis , 1 7 vertigo , 140 Coccygodynia , 274 Conduction aphasia , 48 Cognitive dysfunction, multiple Confusion sclerosis, 393 agitated delirium , 1 Color discrimination , 84 bacterial meningitis , 12–14 Index 417

diagnostic testing , 7–8 Cortical sensory modalities , 232–233 differential diagnosis Corticobasal ganglionic degeneration aphasia , 4 (CBD) , 208 Charles Bonnet syndrome , 7 Corticosteroids , 159 , 403 psychosis , 7 CPS . See Complex partial seizures (CPS) right hemispheric syndrome , 4 , 223 , 242 somatosensory neglect , 6 Cranial nerve , 136 TGA , 6 Cranial polyneuropathy , 106 visual neglect , 4–6 Craniopharyngiomas , 407 drug-induced meningitis , 18 Creatine kinase (CK) ethanol intoxication , 10 elevations , 157 ethanol withdrawal , 10 proximal weakness , 155 examination Creutzfeldt–Jakob disease (CJD) , 77–78 , asterixis , 3–4 217 , 320 inattention , 2 Critical illness myopathy (CIM) , 192–193 months of year backwards , 2 Critical illness polyneuropathy (CIP) , 192 reverse digit span , 3 Cryptococcus neoformans , 1 7 serial sevens , 3 C S F . See Cerebrospinal fl uid (CSF) world backwards , 3 CTA . See Computed tomographic angiography fungal meningitis , 17 (CTA) hepatic encephalopathy , 11 Cutaneous sensory distributions , 231 history , 1 incoherence , 2 leptomeningeal metastasis , 16 D limbic encephalitis , 18 Dalfampridine , 394 Lyme meningitis , 16–17 Dawson fi ngers , 379 NCSE , 19 Deep brain stimulation (DBS) , 203 , 204 , 206 neoplastic meningitis , 16 Deep venous thrombosis (DVT) prophylaxis , NMS , 20–21 365–366 PRES , 19–20 Dementia somnolence , 2 age of onset and tempo , 55 spinal fl uid pleocytosis , 11 alcohol and , 72 structural lesions responsible , 19 Alzheimer disease , 66–67 toxic and metabolic encephalopathies , 8–10 antisaccade test , 61 tuberculous meningitis , 17 behavioral abnormalities , 54 viral meningitis and encephalitis , 14–16 behavioral variant FTD , 67–68 Wernicke encephalopathy , 10–11 bloodwork , 63 Consciousness , 342 B-type test , 62 Constipation , 205–206 CJD , 77–78 Contralateral cerebral cortical , 175 cranial nerve examination , 62 Contrast-enhanced MRI CTE , 73 RRMS , 388 diagnostic testing , 63 multiple sclerosis , 380 DLB , 67 Contrast-enhanced T1-weighted MRI frontal release signs , 61 high-grade glial tumor , 401 functional neuroimaging , 64–65 meningioma , 403 gait diffi culties , 55 , 63 MS , 379 genetic testing , 66 Controversial localized pain syndromes , 259 Hashimoto encephalopathy , 78 Conus medullaris , 179 history , 53 Conventional angiography , 359 HIV dementia , 72 Convergence insuffi ciency , 107 language problem , 54 Convexal subarachnoid hemorrhage leptomeningeal metastasis , 78 MRI , 347 limbic encephalitis , 78 noncontrast head CT , 348 lumbar puncture , 65 418 Index

Dementia (cont. ) Depression Luria test , 60 multiple sclerosis , 392 MCI , 73–74 PD , 204–205 medical history , 55 De Quervain tenosynovitis , 253–255 memory problem , 53 Dermatochalasis , 114 mental fl exibility , 60 Dermatomes , 262 mental status examination Dermatomyositis , 153 , 159–160 attention , 56 Diabetes mellitus construction , 59–60 polyneuropathy , 236 language , 56 stroke , 361 memory problems , 57–58 Diabetic amyotrophy , 257 phonemic fl uency , 57 Dialysis dysequilibrium, seizures , 317 praxis , 58–59 Diarrhea , 203 semantic fl uency , 57 Diazepam , 10 motor examination , 62 Diffusion-weighted MRI (DWI) , 350–351 and movement disorders , 73 Digit span , 3 multi-infarct dementia , 68 Dimethyl fumarate , 390 myoclonus and , 217 Diplopia neurological examination , 61 abducens nerve palsy neurosyphilis , 72–73 cavernous sinus , 99 NPH , 69–71 fascicular lesions , 98 PD , 205 nuclear lesions , 98 postconcussion syndrome , 76 prepontine segment lesions , 98–99 posterior cortical atrophy , 71–72 binocularity and direction , 95 PPA , 71 brainstem encephalitis , 106 praxis , 54 cavernous sinus lesions , 105 primitive refl exes , 61 convergence insuffi ciency , 107 processing speed , 61 cranial polyneuropathy , 106 pseudodementia , 74 diagnostic testing , 108–109 ADHD , 75 Duane retraction syndrome , 100–101 conversion disorders and malingering , 76 dysfunctional eye movement , 96–98 depression , 74 INO , 99–100 medication side effects , 75 MFS , 106 OSA , 74–75 MS , 376 pain , 75 myasthenia gravis , 107–108 sensory examination , 63 ocular misalignment , 96 SMI , 73–74 oculomotor nerve palsy strategic infarct dementia , 69 cavernous sinus lesions , 104 Stroop test , 60 cisternal segment lesions , 104 structural neuroimaging , 63–64 fascicular lesions , 103–104 subcortical white matter disease , 69 nuclear lesions , 102–103 undiagnosed rapidly progressive pupil-sparing third nerve lesions , 104 dementia , 78 orbital lesions , 106 vascular dementia , 68 orbit lesions , 99 , 101 visuospatial function , 54 partial oculomotor , 99 Dementia with Lewy Bodies (DLB) , 67 partial third nerve palsy , 102 Demyelinating disorders restrictive disorders , 107 ADEM , 383–384 right internuclear ophthalmoplegia , 100 neuromyelitis optica , 382–383 skew deviation , 102 PML , 384 of near refl ex , 107 reasonable exclusion of MS , 376 , testing schematic for , 96 384–386 Tolosa–Hunt syndrome , 105–106 Demyelinating lesions , 146 treatment , 109 Demyelinating neuropathy , 185–186 trochlear nerve palsy , 101 Index 419

vertical diplopia , 97 neuromuscular junction lesions , 130 Weber syndrome , 103 nuclear lesions , 129 Wernicke encephalopathy , 104–105 supranuclear lesions , 129 Dipyridamole , 362 treatments , 129 Disease-modifying therapy Dystonia , 203 , 221–222 CIS , 387 Dystonic tremor , 215 MS , 391 Distal embolization , 340 Diurnal variation, headache , 286 E Dix–Hallpike maneuver , 139–140 Early-stage treatment, Parkinson disease , Dizziness , 133 201–202 cervicogenic , 145 Eclampsia , 320–321 chronic undifferentiated , 145 Edrophonium test , 108 epileptic , 144 Elastic stockings , 134 posttraumatic , 145 Electroconvulsive therapy , 205 psychological origin , 146 Electrodiagnostic studies, polyneuropathy , 242 DLB . See Dementia with Lewy Bodies (DLB) Electroencephalography (EEG) Donepezil , 66 epilepsy , 316 Dopamine agonists , 242 seizures , 315–317 Dopamine antagonists , 197 , 208 Electrolyte abnormalities , 317 Dopamine transporter scan , 201 Electromyography (EMG) , 265 Downbeating nystagmus , 138 polyneuropathy , 235 Drug-induced meningitis , 18 proximal weakness , 156 Drug-induced parkinsonism , 208 rapidly progressive weakness , 185–187 Dry mouth , 196 Encephalitis, seizures , 318 Duane retraction syndrome , 100–101 Encephalopathy , 9 Duchenne muscular dystrophy (DMD) , 160 Endpoint nystagmus , 138 Dural arteriovenous fi stula (AVF) , 271 Enhanced physiologic tremor , 213 Duraplasty , 358 Entacapone , 203 Dysarthria , 49–50 Enteroviruses , 14 defi nition , 126 Enzyme-linked immunoelectrotransfer blot extrapyramidal , 127 assay (EITB) , 319 , 410 fl accid , 126 Epidural abscess , 268 high-pitched quivering , 199 Epidural cord compression , 267 pattern of , 126 Epidural steroid injections , 265 PD , 206 Epilepsia partialis continua , 313 scanning , 127 Epilepsy spastic , 126 , 199 autoantibodies , 321 stroke , 127 autoimmune and paraneoplastic , 321 Dysfunctional eye movement , 96–98 EEG , 316 , 203 JME (see Juvenile myoclonic epilepsy Dysphagia (JME)) classifi cation , 127 SPECT studies , 331 for liquids , 128 surgery , 331 oral phase treatment , 326–332 hypoglossal nucleus and nerve lesions , VNS , 331 128–129 withdrawing AEDs , 331–332 trigeminal nerve lesions , 128 Epileptic dizziness , 144 PD , 206 Epileptic seizure , 309 pharyngeal phase Epileptiform discharges , 315 extrapyramidal lesions , 131 Episodic ataxia , 146 glossopharyngeal and vagus nerves , Epley maneuvers , 142 129–130 Epley particle-repositioning maneuvers , 141 myopathic lesions , 130–131 Erythema chronicum migrans , 1 7 420 Index

Essential myoclonus , 218 Fluorescent treponema antibody test Essential tremor , 212 (FTA- ABS) , 73 Ethanol, polyneuropathy , 238 Focal limb weakness Exacerbating factors, headache , 287–288 foot drop Exercise testing , 153–154 CNS localizations , 178–179 Extrapyramidal disease , 151 L5 radiculopathy , 178 Extrapyramidal disorders , 209 motor neuron disease , 178 Extrapyramidal dysarthria, 127 peroneal neuropathy , 177–178 Extrapyramidal lesions, dysphagia, 131 sciatic neuropathy , 178 Extrapyramidal system , 195 treatment , 179 Eyelid-opening apraxia , 115 , 207 hand and fi nger weakness (see Hand and Eye movements, examination , 199 fi nger weakness ) , 180 hemiplegia , 180 F hip and proximal leg weakness (see Hip Facial movement, upper motor neuron , 122 and proximal leg weakness ) Facial nerve multifocal weakness lesions , 125 HNPP , 182 simplifi ed schematic , 122 MMNCB , 181–182 Facial pain vasculitic mononeuropathy multiplex , 181 atypical facial pain syndrome , 306 patterns , 172 glossopharyngeal neuralgia , 304–305 periscapular weakness (see Periscapular herpes zoster , 306 weakness) intermedius neuralgia , 305 postpartum leg weakness , 179–180 postherpetic neuralgia , 306 shoulder weakness , 173 primary headache disorders , 306 wrist and fi nger drop (see Wrist sinus headache , 305 and fi nger drop ) TMJ disease , 305–306 Focal neuropathies , 345 trigeminal neuralgia , 303–304 Focal weakness , 376 Facial weakness Foot drop , 177 anatomy , 121–123 CNS localizations , 178–179 Bell palsy , 125 L5 radiculopathy , 178 central vs . peripheral , 123–124 motor neuron disease , 178 examination , 123 peripheral nervous system , 177 facial nerve lesions , 125 peroneal neuropathy , 177–178 incidental , 125–126 sciatic neuropathy , 178 pontine lesions , 124–125 treatment , 179 supranuclear lesions , 124 Forced vital capacity (FVC) , 183 , 219 Forearm exercise testing , 158 Fatigue , 149 , 392 Fosphenytoin, status epilepticus , 333 Femoral neuropathy , 179 Fresh frozen plasma (FFP) , 367 Fibromyalgia , 244 Frontal eye fi elds (FEF) , 29–30 Finger-to-nose test , 136 Frontal gait , 280 Fingolimod , 392 Frontal release signs , 61 Finkelstein maneuver , 254 Frontotemporal dementia , 320 Finkelstein test , 254 Fulminant multiple sclerosis (MS) , 394–395 First-time seizure . See Seizures Functional visual loss , 92 Flaccid dysarthria , 126 Fungal abscesses , 408 , 409 Flaccidity, weakness , 150 Fungal meningitis , 17 FLAIR MRI hyperintensity , 15 PRES , 20 G

Fluctuating extraocular weakness , 184 GABAA receptor , 18 Fluent aphasics , 44 GABAB receptor , 18 Index 421

Gait disorders Guillain–Barre syndrome (GBS) , 184 , 282 albuminocytologic dissociation , 187 ataxic gait , 281 neurophysiologic hallmark , 185 diffi culties , 55 examination , 198–199 frontal gait , 280 H general neurologic examination , 280 Hallucinations , 205 heel and toe walking , 278 Haloperidol , 21 multifactorial gait disorder , 282 Hand and fi nger weakness natural gait , 277–278 C8–T1 radiculopathy , 175 , 280–281 cerebral causes , 175 parkinsonism , 196 motor neuron disease , 175 provocative maneuvers , 278 ulnar neuropathy , 174 proximal weakness , 154 Hashimoto encephalopathy , 78 PSP gait , 281 Headache psychogenic gait , 282 alleviating factors , 288 pull test , 279 aura , 287 recommendations , 283 carotid artery dissection , 291–292 Romberg sign , 279 character , 286 , 280 chronic daily headache , 302–303 , 281–282 CVST , 293–294 stress gait , 279 diurnal variation , 286 tandem gait , 279 duration , 286 Trendelenburg and Gowers sign , 278 epidemiology , 285 waddling gait , 281 etiology , 285 Galantamine , 66 exacerbating factors , 287–288 Gamma-knife radiosurgery , 393 frequency , 288 Gammopathy , 237 hypertensive encephalopathy , 295 Ganglionopathy , 234 lifestyle modifi cations , 296 Gastrocnemius , 151 medication-related , 299 GBS . See Guillain–Barre syndrome (GBS) meningitis , 294 Generalized pain disorders , 243 , 244 migraine , 293 , 296–297 Generalized tonic–clonic seizure (GTCS) , neurologic symptoms , 287 309–310 , 314 occipital neuralgia , 300 Glasgow coma score (GCS) , 369 , 370 pituitary apoplexy , 292 Glatiramer acetate , 388–389 post-lumbar puncture , 300 Gliomas in pregnancy , 303 deterioration , 402 prior evaluation and treatment , 288–289 low-grade , 402 pseudotumor cerebri , 294–295 meningiomas , 403–404 rapidity of onset , 286 multiple sclerosis , 406 RCVS , 292 radiation necrosis , 403 SAH , 289–290 radiation-induced pseudoprogression , 402 secondary to mass lesions , 294 recurrence , 402 severity and disability level , 288 Global aphasia , 48 status migrainosus , 301–302 Globus pallidus interna (GPi) , 203 TACs , 298 Glossopharyngeal nerves, dysphagia , 129–130 cluster headache , 298 Glossopharyngeal neuralgia paroxysmal hemicrania , 299 facial pain , 304–305 SUNCT , 299 MRI , 305 temporal arteritis , 293 Glucose imbalance, seizures , 317 tension , 297–298 (see Tension headache ) Gowers sign , 278 visual strain , 299 GTCS . See Generalized tonic–clonic seizure Head-thrust test , 139 (GTCS) Hearing loss , 136 422 Index

Heel–knee–shin test , 137 Hypoglycemia, stroke, 347 Hemicraniectomy , 358 Hypotension , 134 Hemifacial spasm , 225 Hypoxic-ischemic injury , 34 Hemiparesis , 180 Hemiplegia , 180 Hemodialysis , 323 I Heparin , 367 Iatrogenic myopathies Hepatic encephalopathy , 11 , 317 alcohol-related myopathies , 162 Hereditary neuropathy with liability to statin-induced myopathy , 161–162 pressure palsies (HNPP) , 182 steroid myopathy , 162 Hereditary spastic (HSP) , 271 Ice test , 108 Herniated nucleus pulposus , 264–265 ICH . See Intracranial hemorrhage (ICH) Herpes simplex virus-1 (HSV-1) , 14 Ictal bradycardia , 144 Herpes simplex virus-2 (HSV-2) , 15 Ictal semiology Herpes zoster , 306 absence seizures , 311 Highly active antiretroviral therapy atonic seizures , 312 (HAART) , 72 CPS , 311 Hip and proximal leg weakness GTCS , 309–310 L2–3 radiculopathy , 176–177 myoclonus , 312 lumbosacral plexopathy , 177 partial seizures , 310 Hollenhorst plaques , 349 sensory seizures , 311 Homonymous hemianopsia , 85 SPS , 310–311 Homonymous upper quadrantanopsia , 90–91 Ideomotor apraxia , 58 , 59 Horizontal nystagmus , 138 Idiopathic brachial neuritis , 249 Horizontal-torsional nystagmus , 138 Idiopathic intracranial hypertension , Human immunodefi ciency virus (HIV), 15 , 238 294–295 dementia , 72 Idiopathic lumbosacral plexitis , 257 Human T-cell leukemia virus (HTLV) , 270 Idiopathic polyneuropathy , 239 Huntington disease (HD) , 197 , 220 , 221 Idiopathic seizures , 321 Hyperacute ischemic stroke Imbalance , 135 acute anticoagulation , 357 Immunocompromised patients acute antiplatelet therapy , 356 fungal abscesses , 409 blood pressure management , 357 PCNSL , 408 clot retrieval devices , 356–357 toxoplasmosis , 408 intravenous rt-PA , 354–356 Immunomodulatory therapy , 257 surgical treatment , 357 , 358 Inclusion body myositis (IBM) , 160 Hypercarbia , 38 Incoherence , 2 Hyperglycemia Incontinence , 392 stroke , 347 Infarction supportive care , 364 ophthalmic artery , 89 Hyperintensity , 14 , 15 vertigo , 140 Hyperkinetic movement disorders Inferior oblique , 103 abnormal facial movements , 225 Inferior rectus , 103 jerking movements , 216–219 Infl ammatory myopathies stiffness and cramping , 223–225 dermatomyositis , 159–160 tardive , 226 IBM , 160 tremor , 211–216 overlap myopathies , 160 twisting and repetitive movements , polymyositis , 159 220–223 proximal weakness , 158–159 twitching , 219 Infl ammatory radiculopathies , 271–273 Hyperlipidemia , 361 Interferon β , 388 , 389 Hypertension , 368 Interferon therapy , 388 Hypertensive encephalopathy , 295 Intermediate stage , 202–204 Hyperthermia, with antipyretics, 364–365 Intermedius neuralgia , 305 Hypoglossal nucleus , 128–129 Internal carotid artery (ICA) , 339–340 Index 423

International Study of Unruptured Intracranial J Aneurysms (ISUIA) , 291 JCV antibodies , 389 , 390 Internuclear ophthalmoplegia (INO) , Joint position perception, sensory symptom , 232 99–100 , 376 Junctional scotoma , 85 , 90 Intervertebral disc herniation syndromes , 265 Juvenile myoclonic epilepsy (JME) , 320 , 321 Intra-arterial tPA, stroke , 356–357 Intracranial aneurysms , 291 Intracranial hemorrhage (ICH) K acute life support , 366 Kernig sign , 12 blood pressure treatment , 368 Ketorolac , 258 , 302 etiology , 368–369 Knee pain , 258 intraparenchymal hemorrhage , 368 noncontrast head CT , 350 prognosis , 369 L restarting anticoagulation , 369–370 Lacunar stroke , 344 reversing anticoagulation Lambert–Eaton myasthenic syndrome heparin , 367 (LEMS) , 130 warfarin , 367 diagnosis , 165 surgical hematoma evacuation , 368 myasthenia gravis , 165–166 Intracranial mass treatment , 165 CPA , 407 Lateral arm pain headaches from , 294 C6 radiculopathy , 250 immunocompromised patients lateral epicondylitis , 250 fungal abscesses , 409 Lateral epicondylitis , 250 PCNSL , 408 Lateral geniculate body (LGB) lesions , 85 toxoplasmosis , 408 Lateral hand pain lesions , 399 CMC , 255 neurocysticercosis , 409–410 CTS , 252–253 sellar region , 406–407 de Quervain tenosynovitis , 253–255 supratentorial masses Leber hereditary optic neuropathy (LHON), 89 abscesses , 406 Left-right symmetry , 196 arteriovenous malformations , 404–406 LEMS . See Lambert–Eaton myasthenic gliomas (see Gliomas ) syndrome (LEMS) metastatic tumors , 399–401 Length-dependent polyneuropathy , 230 , 233 PCNSL , 404 Lennox–Gastaut Syndrome (LGS) , 312 , tumefactive MS , 406 328 , 330 tuberculoma , 410 Leptomeningeal metastasis , 16 Intracranial pressure , 40–41 Levator palpebrae , 103 Intraparenchymal hemorrhage , 368 Levodopa , 202 , 203 Intravenous narcotics , 302 Lhermitte symptom , 376 Intravenous pyridostigmine , 130 Lid retraction , 114 Intravenous recombinant tissue plasminogen Light-headedness activator (IV rt-PA) , 354–356 cardiogenic syncope , 134 Ipsilateral cerebellar hemispheric cause of , 133 dysfunction , 136 neurally mediated syncope , 134–135 Ipsilateral Horner syndrome , 298 orthostatic hypotension , 134 Ischemic strokes POTS , 135 anterior circulation Limb , 136 ACA syndrome , 339 Limb-girdle muscular dystrophies (LGMD) , 161 ICA , 339–340 Limbic encephalitis , 18 MCA syndromes , 337–339 Limb pain, neurologic and musculoskeletal CT , 351 causes , 248 hyperacute (see Hyperacute ischemic stroke ) Limb-shaking transient ischemic attacks , 219 posterior circulation (see Posterior Line bisection test , 5 circulation ischemic strokes ) Logopenic progressive aphasia , 71 424 Index

Long thoracic neuropathy , 173–174 Medial longitudinal fasciculus (MLF) , 98 Lorazepam , 10 Medication-related headache , 299 Lower brainstem symptoms , 121 Medications, seizures , 318 Lower quadrantanopsia , 85 Memantine , 66 Lower trunk brachial plexopathy , 173 , 251–252 Meniere disease , 142–143 Lumbar puncture , 315 Meningioma bacterial meningitis , 12–14 contrast-enhanced T1-weighted MRI , 403 coma , 35–36 CPA masses , 407 oligoclonal bands , 382 gliomas , 403–404 visual evoked potentials , 382 radiologic differential diagnosis , 404 Lumbosacral plexopathy , 177 , 179 Meningitis cancer , 257 headache , 294 diabetic amyotrophy , 257 seizures , 318 idiopathic lumbosacral plexitis , 257 Mental fl exibility , 60 neoplasm-related , 257 Mental retardation , 377 retroperitoneal hematoma , 256 Mental status , 199 thigh and hip pain , 256 Meralgia paresthetica , 256 trauma , 256 Metabolic insult causing re-expression of old Lumbosacral polyradiculopathy , 241 stroke (MICROS) , 345 Luria test , 60 Metachromatic leukodystrophy (MLD) , 270 Lyme meningitis , 16–17 Metastatic cord compression , 268 Metastatic tumors , 399–401 Methylphenidate , 314 M Mid-basilar artery occlusion , 342 Macular edema , 390 Mid-basilar penetrating branch occlusion , 342 Macular-sparing homonymous hemianopsia, 85 Middle cerebral artery (MCA) Magnetic resonance angiography (MRA) branches , 337 , 338 cerebral vasculature , 353 left vs . right , 339 RCVS , 292 malignant , 358 stroke , 359 syndromes , 337–339 Magnetic resonance imaging (MRI) Migraine abscess , 406 differential diagnosis , 312–313 ANM , 404 headache , 293 , 296–297 axial FLAIR , 400 prophylactic agents , 297 brain , 200–201 vertigo , 143–144 convexal subarachnoid hemorrhage, 347 , 348 Migraine aura glossopharyngeal neuralgia , 305 focal defi cits in , 346 metastasis , 400 stroke defi cits , 346 MS , 377–381 without headache , 89–90 neurocysticercosis , 410 Mild cognitive impairment (MCI) , 73–74 vertigo , 140 Miller Fisher syndrome (MFS) , 106 Magnetic resonance spectroscopy (MRS) , 402 Minimally conscious state (MCS) , 38 Magnetic resonance venography (MRV) , 353 Mixed transcortical aphasia , 48–49 Malignant MCA syndrome , 358 Modafi nil , 314 MAO-B inhibitors , 202 Monoclonal gammopathy of undetermined Mass lesions, headache secondary , 294 signifi cance (MGUS) , 237 MCA . See Middle cerebral artery (MCA) Monocular altitudinal defect , 85 MCI . See Mild Cognitive Impairment (MCI) Monocular visual loss , 85 Medial epicondylitis , 252 Mononeuropathy multiplex , 181 Medial hand and arm pain Morton neuroma , 242 C8 radiculopathy , 251 Motor impairments , 393–394 lower trunk brachial plexopathy , 251–252 Motor nerve conduction , 157 , 166 , 167 medial epicondylitis , 252 Motor neuron disease , 175 , 178 ulnar neuropathy , 250–251 Motor pathways , 171 Index 425

Motor seizures , 310 physical examination , 378 Motor syndromes , 376 primary demyelinating disorders Motor system , 172 ADEM , 383–384 Movement disorders neuromyelitis optica , 382–383 dementia and , 73 PML , 384 differential diagnosis , 313 RRMS (see Relapsing-remitting MS MRA . See Magnetic resonance angiography (RRMS) ) (MRA) secondary demyelinating disorders , 384–386 MRI . See Magnetic resonance imaging (MRI) spasticity , 391 Multifocal demyelination , 384 spine MRI , 381 Multifocal motor neuropathy with conduction T1 black holes , 379–381 block (MMNCB) , 181–182 T2 and FLAIR , 378–379 Multifocal weakness tonic , 394 HNPP , 182 tremor , 393 MMNCB , 181–182 tumefactive , 406 vasculitic mononeuropathy multiplex , 181 urinary dysfunction , 391–392 Multi-infarct dementia , 68 Multiple sleep latency test (MSLT) , 314 Multiple sclerosis (MS) Multisystem atrophy (MSA) , 207 back pain , 269 Muscle atrophy , 150 CIS , 375 Muscle biopsy , 156–157 atypical symptoms , 377 Muscle bulk , 150–151 , 153 diplopia , 376 Muscle relaxants , 298 disease-modifying treatment , 387 Muscle strength , 153 incoordination , 376 Muscle weakness , 262 motor syndromes , 376 Muscular dystrophies multifocal and progressive DMD , 160 presentations , 377 LGMD , 161 myelopathy , 375 Musculoskeletal back pain optic neuritis , 386–387 coccygodynia , 274 radiologically isolated syndrome , 377 sacroiliac joint dysfunction , 274 sensory syndromes , 376 spinal fractures , 273–274 treatment , 387 strains and sprains , 273 visual loss , 375 Musculoskeletal system dysfunction , 149 cognitive dysfunction , 393 Myasthenia gravis , 107–108 , 112 , 163–165 contrast-enhanced coronal MRI , 380 Myasthenic crisis , 189 contrast-enhanced T1-weighted Myelopathy imaging , 379 back pain , 262–263 (see also Back pain ) CSF , 378 , 381 , 383 , 384 CIS , 375 dalfampridine , 394 NMO , 383 depression and anxiety , 392 Myoclonic epilepsy , 217 differential diagnosis , 385 , 386 Myoclonic seizures , 312 disease-modifying agents , 383 Myoclonus , 62 disease-modifying therapy , 391 acute post-anoxic , 217 evaluation , 378 chronic post-anoxic , 217 fatigue , 392 and dementia , 217 FLAIR MRI , 379 , 380 , 394 essential myoclonus , 218 fulminant variants , 394–395 physiologic myoclonus , 218 immunomodulatory therapy , 393 segmental myoclonus , 218 lumbar puncture , 381 , 382 toxic and metabolic , 216 motor impairments , 393–394 Myoedema , 155 MRI , 378–381 Myofascial pain syndrome , 259 pain and paresthesias , 393 , 225 past history , 378 Myopathic lesions, dysphagia , 130–131 patience , 382 Myopathy , 186 426 Index

Myositis-associated antibodies , 157–158 subarachnoid hemorrhage , 290 Myotomes , 262 subdural hematoma , 347 Myotonia Nonconvulsive status epilepticus (NCSE) , 19 congenita , 224–225 Nonfl uent aphasics , 44 myotonic dystrophy , 224 Nonfl uent progressive aphasia , 71 paramyotonia congenita , 224–225 Non-length-dependent polyneuropathy , 234 Nonmotor symptoms treatment constipation , 205–206 N dementia , 205 NAION . See Nonarteritic Ischemic Optic depression , 204–205 Neuropathy (NAION) dysarthria , 206 Narcolepsy , 314 dysphagia , 206 Natalizumab hallucinations and psychosis , 205 PML , 384 Non-neurologic back pain , 273 RRMS , 389–390 Nonsteroidal anti-infl ammatory drugs NCSE . See Nonconvulsive status epilepticus (NSAIDs) , 244 , 258 (NCSE) Normal pressure hydrocephalus (NPH) , 69–71 Neologisms , 44 Nuclear lesions , 129 Neoplasm Numbness , 229 back pain , 267–268 Nystagmus seizures , 319 bruns , 138 Neoplastic meningitis , 16 downbeating , 138 Nerve biopsy, polyneuropathy , 235 due to vestibular neuritis , 141 Nerve conduction studies (NCS) , 166 endpoint , 138 polyneuropathy , 235 horizontal/horizontal-torsional , 138 proximal weakness , 156 torsional , 138 rapidly progressive weakness , 185–187 upbeating , 138 Nerve lesions, dysphagia , 128–129 vertigo , 137–138 Neurally mediated syncope, light-headedness , 134–135 Neurocognitive symptoms , 244 O Neurocysticercosis , 319 , 409–410 Obstructive sleep apnea (OSA) , 74–75 Neurodegenerative diseases, seizures , 320 Obturator neuropathy , 179 Neurogenic claudication , 267 Occipital neuralgia , 300 Neurolabyrinthitis , 141 Oculopharyngeal muscular dystrophy Neuroleptic malignant syndrome (NMS), 20–21 (OPMD) , 113 , 130 Neuromuscular junction lesions , 112–113 , 130 Oculosympathetic pathway , 113 Neuromuscular respiratory failure, 183 Oligoclonal bands (OCBs) , 382 Neuromyelitis optica (NMO) , 382–383 Ophthalmic artery infarction , 89 Neuropathic pain , 229 Opsoclonus , 139 , 217–218 Neuropathic tremor , 215 Optic disc pallor , 86 Neurosyphilis , 72–73 Optic neuritis , 386–387 Neutralizing antibodies (NAbs) , 389 Optic Neuritis Treatment Trial (ONTT) , 386 NMS . See Neuroleptic malignant syndrome Optic neuropathy , 386 (NMS) Oral phase dysphagia Nociceptive pain treatment , 258–259 hypoglossal nucleus and nerve lesions , Nonarteritic ischemic optic neuropathy 128–129 (NAION) , 88 trigeminal nerve lesions , 128 Noncontrast head CT Oral triptan , 296 convexal subarachnoid hemorrhage , 348 Orbit lesions , 99 , 101 intracranial hemorrhage , 350 Orbitofrontal automatisms , 311 SAH , 289 Oromandibular dystonia , 225 seizure , 315 Oropharyngeal bradykinesia , 206 stroke , 349–351 Orthostasis , 200 Index 427

Orthostatic hypotension , 134 family history , 197 OSA . See Obstructive sleep apnea (OSA) gait dysfunction and falls , 196 , 258 history , 195 Overlap myopathies , 160 left-right symmetry , 196 Overshoot phenomenon, vertigo , 137 medications and toxins , 197 pace of onset , 195 presence of tremor , 196 P vascular , 208–209 Palatal tremor , 215 Paroxysmal hemicrania , 299 Palmar sensory branch , 253 Partial seizure Pan-plexopathy , 173 GTCS , 309 Papilledema , 295 ictal semiology , 310 Paramedian thalamic-subthalamic artery , 343 Patchy spinal cord lesions , 376 Paramyotonia congenita , 224–225 PD . See Parkinson disease (PD) Paraneoplastic cerebellar degeneration , 146 Pentobarbital coma , 333 Paraneoplastic epilepsy , 321 Perfusion-weighted imaging (PWI) , 352 Paraphasic errors , 44 Perilymph fi stula , 144 Paratonia , 62 , 151 Perimenstrual migraines , 297 Paresthesia , 229 Peripheral nervous system , 177 Parkinson disease (PD) , 127 , 196 Peripheral vestibulopathy , 348 advanced stage treatment , 204 Periscapular weakness cardinal features , 201 long thoracic neuropathy , 173–174 early-stage treatment , 201–202 spinal accessory neuropathy , 174 intermediate stage , 202–204 Peroneal neuropathy , 177–178 medications , 205 Persistent vegetative state (PVS) , 37–38 nonmotor symptoms Phalen sign , 254 constipation , 205–206 Pharyngeal exudate , 184 dementia , 205 Pharyngeal phase dysphagia depression , 204–205 extrapyramidal lesions , 131 dysarthria , 206 glossopharyngeal and vagus nerves , dysphagia , 206 129–130 hallucinations and psychosis , 205 myopathic lesions , 130–131 Parkinsonian gait , 280–281 neuromuscular junction lesions , 130 Parkinsonian tremor , 214–215 supranuclear lesions , 129 Parkinsonism , 62 Phenytoin , 325 activities of daily living , 197 Phonemic fl uency , 57 age of onset , 195 Phosphocreatine , 155 ataxia , 196 Physiologic myoclonus , 218 atypical (see Atypical parkinsonism ) Pinprick examination , 230–232 autonomic dysfunction , 196 Pituitary apoplexy , 292 brain MRI , 200–201 Plantar fasciitis , 241 dementia , 197 Plaques , 378 , 379 diagnosis , 200 Plasmapheresis , 188 dopamine transporter scan , 201 PML . See Progressive multifocal drug-induced , 208 leukoencephalopathy (PML) examination Polar artery, thalamic strokes , 343 bradykinesia , 198 Poliomyelitis, acute paralysis , 191 eye movements , 199 Polymerase chain reaction (PCR) , 17 gait , 198–199 Polymyositis , 159 mental status examination , 199 Polyneuropathy orthostasis , 200 acute paralysis , 190–191

rigidity , 197–198 B12 defi ciency , 236 speech , 199 CMT disease , 238 tremor , 198 diabetes mellitus , 236 428 Index

Polyneuropathy (cont. ) Progressive multifocal leukoencephalopathy EMG , 235 (PML) , 384 , 389 ethanol , 238 Progressive supranuclear palsy (PSP) HIV , 238 clinical features , 206–207 idiopathic , 239 gait , 281 laboratory screening , 234–235 Prolonged neuromuscular junction length-dependent , 233 blockade , 193 medication , 239 Prominent gait instability , 206 monoclonal gammopathy , 237 Prophylactic agents , 297 NCS , 235 Prophylaxis , 143 nerve biopsy , 235 Proprioceptive sensations , 230 non-length-dependent , 234 Prosopagnosia , 93 screening panel , 234 Prothrombin complex concentrate (PCC) , 367 thyroid dysfunction , 238–239 Provoked seizures , 322 vasculitis , 237 Proximal weakness Pontine lesions , 124–125 , 376 CIDP , 166–168 Postconcussion syndrome , 76 , 145 CNS dysfunction , 168 Posterior cerebral artery (PCA) infarction , exercise testing , 153–154 91 , 342 features , 153 Posterior choroidal artery, thalamic strokes, 343 gait , 154 Posterior circulation ischemic strokes , history , 151–153 340–341 infl ammatory myopathies cerebellar strokes , 343–344 dermatomyositis , 159–160 mid-basilar artery occlusion , 342 IBM , 160 mid-basilar penetrating branch overlap myopathies , 160 occlusion , 342 polymyositis , 159 PCA infarction , 342 laboratory testing rostral basilar occlusion , 342 aldolase , 156 thalamic strokes , 343 creatine kinase , 155 , 156 Wallenberg syndrome , 341 EMG , 156 Posterior cortical atrophy , 71–72 forearm exercise testing , 158 Posterior reversible encephalopathy syndrome muscle biopsy , 156–157 (PRES) , 19–20 , 92 , 295 myositis-associated antibodies, Postherpetic neuralgia , 306 157–158 Post-lumbar puncture headache , 300 NCS , 156 Postpartum leg weakness , 179–180 muscle bulk , 153 Postsynaptic neuromuscular junction muscle strength , 153 dysfunction , 186 muscular dystrophies Posttraumatic dizziness , 145 DMD , 160 Posttraumatic seizures , 318 LGMD , 161 Postural orthostatic tachycardia syndrome myasthenia gravis , 163–166 (POTS) , 135 refl exes , 154 PPA . See Primary progressive aphasia (PPA) sensory examination , 154 Praxis , 54 , 155 Preeclampsia , 320 thyroid myopathies , 161 Pregnancy, headache , 303 toxic and iatrogenic myopathies , 161–162 PRES . See Posterior reversible encephalopathy Pseudoseizures , 327 , 328 syndrome (PRES) Pseudotumor cerebri , 294–295 Presynaptic neuromuscular junction Psychiatric disorders , 314 dysfunction , 186 Psychogenic gait , 282 Primary central nervous system lymphoma Psychogenic tremor , 216 (PCNSL) , 404 , 408 Psychosis , 7 , 205 Primary progressive aphasia (PPA) , 71 Ptosis , 155 Primary progressive MS (PPMS) , 391 fl uctuating extraocular weakness , 184 Primitive refl exes , 61 muscle lesions , 113–114 Index 429

nerve lesions Raynaud phenomenon , 243 facial nerve , 112 Rebound, vertigo , 137 oculomotor nerve , 111 Red fl ags , 264 oculosympathetic nerves , 112 Refl exes neuromuscular junction lesions , 112–113 proximal weakness , 154 soft tissue lesions , 114 sympathetic dystrophy , 259 supranuclear lesions , 111 Refractory epilepsy , 326–332 treatment , 114 Refractory symptoms , 143 , 392 Pupil-sparing third nerve lesions , 104 Rehabilitation program , 366 PVS . See Persistent vegetative state (PVS) Relapsing-remitting MS (RRMS) contrast-enhanced MRI , 388 dimethyl fumarate , 390 Q fi ngolimod , 390 Quadrantanopsia , 85 glatiramer acetate , 388–389 interferon β , 388 , 389 natalizumab , 389–390 R terifl unomide , 390 Radial neuropathy , 176 treatment of MS fl ares , 388 Radiation-induced brachial plexopathy , 249 Relative afferent pupillary defect (RAPD) , Radiation-induced pseudoprogression, 83–84 , 375 , 378 gliomas , 402 Renal dysfunction , 323 Radiation necrosis, gliomas , 403 Repetitive nerve stimulation (RNS) , 163 , 164 Radiculopathies Restless legs syndrome (RLS) , 242–243 back pain (see Back pain ) Retinal ischemia , 89 infl ammatory , 271–273 Retroperitoneal hematoma , 256 Radiculopathy Reversible cerebral vasoconstriction syndrome C5 , 173 , 248 (RCVS) , 292 C6 , 173 , 250 Right hemispheric syndrome , 4 C8 , 251 Rigidity C8–T1 , 175 axial , 207 L2 and L3 , 176–177 , 255 parkinsonism , 197–198 L5 , 178 Rivastigmine , 66 Radiofrequency ablation (RFA) , 304 Romberg sign , 233 , 279 Radiologically isolated syndrome , 377 Rostral basilar occlusion , 342 RAPD . See Relative afferent pupillary defect Rotator cuff tendonitis , 250 (RAPD) Rapid eye movement (REM) , 54 Rapidly progressive weakness S axonal neuropathy , 186 Sacroiliac joint dysfunction , 274 blood, urine, and stool examination , 187 Scapular winging CSF analysis , 187 long thoracic neuropathy , 173–174 demyelinating neuropathy , 185–186 spinal accessory neuropathy , 174 diagnostic studies Sciatic neuropathy , 178 EMG , 185–187 Secondary prevention, stroke , 360 NCS , 185–187 anticoagulation , 361–362 neuroimaging studies , 185 antiplatelet therapy , 362 initial pattern , 183–184 blood pressure control , 360 myopathy , 186 carotid stenosis , 362–363 neurologic examination , 184 CEA , 362–363 neuromuscular respiratory failure , 183 diabetes mellitus , 361 neuropathies , 191 hyperlipidemia , 361 postsynaptic neuromuscular junction interventions , 364 dysfunction , 186 lifestyle recommendations , 361 presynaptic neuromuscular junction Secondary progressive MS (SPMS) , 391 dysfunction , 186 Secondary tremor , 214 430 Index

Segmental myoclonus , 218 Semantic dementia , 71 Seizures Semantic fl uency , 57 AED , 322–323 Sensory examination , 154 alcohol withdrawal , 318 Sensory innervation , 251 arteriovenous malformations , 320 Sensory loss , 149 , 176 , 261 , 262 autoimmune and paraneoplastic Sensory seizures , 311 , 313 epilepsy , 321 Sensory symptoms counseling after , 323–325 anatomy , 230 differential diagnosis , 327 CIS , 376 migraine , 312–313 cortical sensory modalities , 232–233 movement disorders , 313 cramps , 242 narcolepsy , 314 morton neuroma , 242 psychiatric disorders , 314 MS , 393 sensory symptoms , 313 neuropathic treatment , 239–241 syncope , 312 overview , 229–230 transient ischemic attack , 312–313 pinprick and temperature sensation , eclampsia , 320–321 230–232 EEG , 316 plantar fasciitis , 241 electroencephalography , 315–317 Raynaud phenomenon , 243 electrolyte abnormalities , 317 RLS , 242–243 encephalitis , 318 spine disease , 241 etiology , 314–315 tarsal tunnel syndrome , 241–242 evaluation , 309–325 vibratory and joint position perception , 232 glucose imbalance , 317 Short-acting anxiolytics , 392 hemorrhagic stroke , 319 Shortlasting unilateral neuralgiform headaches hepatic encephalopathy , 317 with conjunctival injection and ictal semiology tearing (SUNCT) , 299 absence seizures , 311 Shoulder and proximal arm pain atonic seizures , 312 brachial plexopathy , 248 CPS , 311 cancer , 249 GTCS , 309–310 idiopathic brachial neuritis , 249 myoclonus , 312 trauma , 248–249 partial seizures , 310 C5 radiculopathy , 248 SPS , 310–311 rotator cuff tendonitis , 250 idiopathic , 321 Shoulder weakness JME , 320 brachial plexopathy , 173 laboratory testing , 315 C5–6 radiculopathy , 173 medication , 318 , 327 Simple partial seizures (SPS) meningitis , 318 behavioral and psychic seizures , 311 neoplasms , 319 motor seizures , 310 neurocysticercosis , 319 sensory seizures , 311 neurodegenerative diseases , 320 Sinus headache , 305 neuroimaging , 315 Skin-nerve biopsy , 235 noncontrast head CT , 315 SMI . See Subjective memory impairment (SMI) posttraumatic , 318 Somatosensory defi cits , 313 provoked , 322 Somatosensory neglect , 6 recurrence chance , 322 Somnolence , 2 stroke , 319–320 Spasmodic dysphonia , 127 and syncope , 313 Spastic dysarthria , 126 , 199 , 206 toxins , 318 Spastic gait , 280 uremia and dialysis dysequilibrium , 317 Spasticity Selective serotonin reuptake inhibitors multiple sclerosis , 391 (SSRIs) , 204 weakness , 151 Sellar region, intracranial mass , 406–407 Speech, examination , 199 Index 431

Spetzler–Martin AVM grading scale, 405 cardiac evaluation , 358–359 Spinal accessory neuropathy , 174 causes of , 360 Spinal cord cerebral venous thrombosis , 344 cross-sectional diagram , 263 convexal subarachnoid hemorrhage , 347 infarction , 269–270 DWI , 350–351 insults, acute paralysis , 191 focal neuropathies , 345 stroke, treatment , 270 , 344 funduscopic examination , 349 Spinal fl uid pleocytosis , 11 hyperacute ischemic stroke Spinal fractures , 273–274 cerebellar infarction , 358 Spinal stenosis intra-arterial tPA , 356–357 conservative therapy , 267 intravenous rt-PA , 354–356 L2–3 radiculopathy , 176 malignant MCA syndrome , 358 manifestation , 266 hyperglycemia , 347 Spine MRI, MS , 381 hypoglycemia , 347 Spontaneous intracranial hypotension (SIH) , ICH , 344 300 , 301 acute life support , 366 Spontaneous speech , 44 blood pressure treatment , 368 Statin-induced myopathy , 161–162 etiology , 368–369 Status epilepticus heparin , 367 abort seizures , 332–334 intraparenchymal hemorrhage , 368 AEDs , 333 prognosis , 369 burst-suppression , 334 restarting anticoagulation , cause , 335 369–370 convulsive vs . nonconvulsive , 332 surgical hematoma evacuation , 368 defi nition , 332 warfarin , 367 etiology , 334 laboratory studies , 349 life support , 332 lacunar , 344 pentobarbital coma , 333 MICROS , 345 Status migrainosus migraine aura , 346 acute pain control , 302 noncontrast head CT , 349–351 antiemetic agents , 301 peripheral vestibulopathy , 348 migraine abortive agents , 302 physical examination , 349 steroids , 302 posterior circulation ischemic strokes supportive care , 301 cerebellar strokes , 343–344 Steppage gait , 281–282 mid-basilar artery occlusion , 342 Steroids mid-basilar penetrating branch myopathy , 162 occlusion , 342 status migrainosus , 302 PCA infarction , 342 Steroid-sparing agent , 159 rostral basilar occlusion , 342 Stiff person syndrome , 223 thalamic strokes , 343 Stocking-glove sensory loss , 233 Wallenberg syndrome , 341 test , 261 psychogenic disorders , 348 Strains and sprains , 273 PWI , 352 Strategic infarct dementia , 69 SDH , 346–347 Stress gait , 279 secondary prevention , 360 Stroke anticoagulation , 361–362 acute confusional state , 345 antiplatelet therapy , 362 anterior circulation ischemic strokes blood pressure control , 360 ACA syndrome , 339 carotid stenosis , 362–363 ICA , 339–340 CEA , 362–363 MCA syndromes , 337–339 diabetes mellitus , 361 antiplatelet agents , 363 hyperlipidemia , 361 Bell palsy , 348 interventions , 364 blood tests , 359–360 lifestyle recommendations , 361 432 Index

Stroke ( cont. ) metastatic tumors , 399–401 seizures , 319–320 PCNSL , 404 spinal cord , 344 tumefactive MS , 406 supportive care Swallowing . See Dysphagia aspiration prevention , 365 Syncope , 312 , 313 assessing aspiration risk , 365 , 126 DVT prophylaxis , 365–366 hyperglycemia , 365 hyperthermia and infection , 364–365 T maintaining adequate nutrition , 365 T1 black holes , 379–381 preventing falls , 366 T1 radiculopathy , 175 rehabilitation program , 366 Taenia solium , 319 susceptibility imaging , 351–352 Tandem gait , 279 TGA , 346 Tangier disease , 234 Todd paralysis , 346 Tardive dyskinesia (TD) , 226 vascular evaluation , 359 Tarsal tunnel syndrome , 241–242 vascular imaging studies , 352 Task-specifi c dystonias , 222–223 wrist and fi nger drop , 175 , 176 Task-specifi c tremor , 216 Stroop test , 60 TCMA . See Transcortical motor aphasia Subarachnoid hemorrhage (SAH) (TCMA) convexal , 347 , 348 TD . See Tardive dyskinesia (TD) headache , 289–290 Temozolomide , 402 non-contrast head CT , 289 , 290 Temperature sensation , 230–232 Subcortical aphasias , 49 Temporal arteritis Subcortical dementia , 393 headache , 293 Subcortical white matter disease , 69 risk for , 289 Subdural hematoma (SDH) symptoms , 287 diagnosis , 346 Temporal crescent defects , 86 non-contrast head CT , 347 Temporomandibular joint (TMJ) disease , Subjective memory impairment (SMI) , 73–74 305–306 Suboccipital decompressive craniectomy , 358 Tension headache , 286 , 297–298 Subthalamic nucleus (STN) , 203 Terifl unomide , 390 Sumatriptan , 296 , 297 TGA . See Transient global amnesia (TGA) SUNCT . See Shortlasting unilateral Thalamic strokes , 343 neuralgiform headaches with Thalamogeniculate artery, thalamic strokes , 343 conjunctival injection and tearing Thigh and hip pain (SUNCT) lumbosacral plexopathy , 256 Superior rectus , 103 cancer , 257 Super-refractory status epileptus , 334 diabetic amyotrophy , 257 Supranuclear dysfunction , 199 idiopathic lumbosacral plexitis , 257 Supranuclear gaze palsy , 207 retroperitoneal hematoma , 256 Supranuclear lesions trauma , 256 facial weakness , 124 L2 and L3 radiculopathy , 255 dysphagia , 129 meralgia paresthetica , 256 Supratentorial masses osteoarthritis , 258 abscesses , 406 trochanteric bursitis , 257 arteriovenous malformations , 404–406 Thoracic spine , 272 gliomas , 401–402 Thyroid dysfunction , 238–239 deterioration , 402 Thyroid myopathies , 161 meningiomas , 403–404 Tics , 219 radiation necrosis , 403 Tinel sign , 253 radiation-induced Todd paralysis , 310 , 346 pseudoprogression , 402 Tolosa–Hunt syndrome , 105–106 recurrence , 402 Tongue weakness , 128 Index 433

Tonic spasms , 394 Trochanteric bursitis , 257 Torsional nystagmus , 138 Trochlear nerve palsy , 101 Toxic myopathies , 161 Tropical spastic paraparesis , 270 alcohol-related myopathies , 162 Truncal ataxia, vertigo , 137 statin-induced myopathy , 161–162 Tuberculoma , 410 steroid myopathy , 162 Tuberculous meningitis , 17 Toxoplasmosis , 408 Tumefactive multiple sclerosis , 406 Transcortical motor aphasia (TCMA) , 48 Transcortical sensory aphasia , 48–49 Transesophageal echocardiography (TEE), 359 U Transient global amnesia (TGA) , 6 , 346 Ulnar neuropathy , 174 , 250–251 Transient ischemic attack (TIA) , 312–313 , 337 Upbeating nystagmus , 138 Transtentorial herniation , 40 Upper quadrantanopsia , 85 Transthoracic echocardiography (TTE) , 359 Upper trunk brachial plexopathy , 173 Transverse cord infarction , 269 Uremic seizures , 317 Transverse myelitis Urinary dysfunction , 391–392 back pain , 269 MS , 375 Trauma V brachial plexopathy , 248–249 Vagus nerves, dysphagia , 129–130 carotid artery dissection , 291 Vagus nerve stimulator (VNS) , 331 lumbosacral plexopathy , 256 Valacyclovir , 125 Traumatic brain injury (TBI) , 76 Valproate, status epilepticus , 333 Tremor Vascular claudication , 267 CBD , 208 Vascular dementia , 65 , 68 cerebellar outfl ow tremor , 215 Vascular evaluation , 359 dystonic tremor , 215 Vascular imaging, stroke , 352 enhanced physiologic tremor , 213 Vascular parkinsonism , 208–209 essential tremor , 212 Vascular syndromes , 343 examination , 198 Vasculitic mononeuropathy multiplex , 181 medications producing , 214 Vasculitic neuropathies , 237 multiple sclerosis , 393 Vasogenic edema , 399 , 400 neuropathic tremor , 215 Ventilator, diffi culty weaning from palatal tremor , 215 CIM , 192–193 parkinsonian tremor , 214–215 CIP , 192 parkinsonism , 196 prolonged neuromuscular junction psychogenic tremor , 216 blockade , 192–193 secondary tremor , 214 Ventralis intermedius (VIM) , 393 task-specifi c tremor , 216 Vertebrobasilar disease , 140 Wilson disease , 212–213 Vertebroplasty , 274 , 154–155 Vertigo Trendelenburg sign , 278 BPPV , 141–142 Tricyclic antidepressants , 204 cerebellar signs , 136 Trigeminal autonomic cephalalgias (TACs) fi nger-to-nose test , 136 cluster headache , 298 heel–knee–shin test , 137 paroxysmal hemicrania headaches , 299 overshoot , 137 SUNCT , 299 rebound , 137 Trigeminal nerve lesions, dysphagia , 128 truncal ataxia , 137 Trigeminal neuralgia , 376 , 393 cervicogenic dizziness , 145 cause of , 304 chronic undifferentiated dizziness , 145 facial pain , 303–304 CPA tumors , 145 Triptans CT scan , 140 side effects , 296 Dix–Hallpike maneuver , 139–140 symptomatic treatment , 297 dizziness of psychological origin , 146 434 Index

Vertigo (cont. ) monocular visual loss , 86 epileptic dizziness , 144 NAION , 88 episodic ataxia , 146 neuroanatomy , 82 head-thrust test , 139 neuroanatomy of , 81–82 imaging , 140 optic neuritis , 86–87 medication toxicity , 144 retinal ischemia and infarction , 89 Meniere disease , 142–143 structural optic neuropathies , 88 migraine , 143–144 temporal arteritis , 87–88 MRI , 140 toxic and nutritional optic neuropathies , 88

multiple sclerosis , 146 Vitamin B12 defi ciency , 269 nystagmus , 137–138 Vitamin K , 367 paraneoplastic cerebellar degeneration , 146 perilymph fi stula , 144 postconcussion syndrome and W posttraumatic dizziness , 145 Waddling gait , 281 vertebrobasilar ischemia and infarction, 140 Wallenberg syndrome , 341 vestibular neuritis , 141 Watershed infarction , 340 Vestibular schwannomas , 407 Weakness Vestibulotoxic medications , 144 defi nition , 149 Vibratory perception , 232 fl accidity , 150 Vibratory sensations , 230 gradual-onset patterns , 150 Viral encephalitis , 14–16 history , 150 Viral meningitis , 14–16 mimics , 149 Viral prodrome , 145 muscle bulk , 150–151 Visual apperceptive agnosia , 93 paratonia , 151 Visual evoked potentials (VEPs) , 382 power , 151 Visual loss proximal alexia without agraphia , 91 aldolase , 156 bitemporal hemianopsia , 90 CIDP , 166–168 CIS , 375 CNS dysfunction , 168 cortical blindness creatine kinase , 155 , 156 bilateral occipital lobe infarction , 91 exercise testing , 153–154 PRES , 92 features , 153 functional visual loss , 92 forearm exercise testing , 158 history , 82 gait , 154 homonymous upper quadrantanopsia , 90–91 genetic test , 158 junctional scotoma , 90 history , 151–153 PCA infarctions , 91 infl ammatory myopathies , Visual neglect , 4–6 158–160 Visual object agnosia , 93 muscle biopsy , 156–157 Visual strain headache , 299 muscle bulk , 153 Visual system muscle strength , 153 angle closure glaucoma , 90 muscular dystrophies , 160 , 161 examination myasthenia gravis , 163–166 central visual fi elds , 84 myositis-associated antibodies , color discrimination , 84 157–158 funduscopic examination , 86 NCS , 156 peripheral visual fi elds , 84–86 refl exes , 154 pupillary reactions , 83 sensory examination , 154 RAPD , 83–84 signs and symptoms , 155 visual acuity , 82 thyroid myopathies , 161 inherited optic neuropathies , 89 toxic and iatrogenic myopathies , migraine aura , 89–90 161–162 Index 435

rigidity , 151 Willis–Ekbom disease . See Restless legs shoulder (see Shoulder weakness ) syndrome (RLS) spasticity , 151 Wilson disease , 197 , 212–213 tested movements , 152 Word-fi nding diffi culties , 54 Wernicke aphasia , 47 Wrist and fi nger drop Wernicke encephalopathy, 10–11 , radial neuropathy , 176 104–105 stroke , 175 , 176