A young woman is ‘talking to voices’ and is admitted to the psychiatric unit. Does she have a mental illness, or is something else going on?
The Magic of the Neuro Exam
April 18, 2011 By 4 Comments
The neurological exam in 3 minutes, on video – the highest form of art?
EBM Migraine
November 3, 2010 By Leave a Comment
Migraine without aura (‘common’ migraine). 66-75% of migraineurs; must have had at least five attacks. Attacks lasting 4-72 hours untreated. At least 2 of headache characteristics: unilateral, pulsating or throbbing, moderate to severe, aggravated by movement. At least 1 associated symptom during headache: nausea and/or vomiting, photophobia and phonophobia.
EBM Status Epilepticus
October 31, 2010 By 2 Comments
Status Epilepticus: Synonyms: overt, geneneralised tonic-clinic, major motor SE. Defined as a seizure lasting over 5 mins, or two or more seizures without recovery in between.
Clinical Neurology a primer
October 7, 2010 By 2 Comments
Book Review on Clinical Neurology a primer, written by neurologist Dr Peter Gates.
A Stroke of Insight
September 19, 2010 By Leave a Comment
A few years ago I was looking after an elderly woman in the emergency department who had suffered a stroke. She was aphasic — unable to understand speech or create comprehensible sentences. I explained to her family what had happened to her. Then her daughter asked me a question for which I hadn’t prepared an answer: “What does it feel like to have a stroke?”
Eye movements, coma and pseudocoma
July 16, 2010 By Leave a Comment
A man is about to intubated for coma. What can be learned from a rapid neurological exam that includes assessment of eye movements? Could this be a pseudocoma?
Coma and small pupils
October 20, 2009 By 4 Comments
aka Neurological Mind-boggler 002 You are asked to review a 65 year-old man who is comatose (GCS 3) with small pupils (2 mm bilaterally). He has a history of diabetes mellitus and bipolar disorder. He was discharged from hospital yesterday, following a surgical procedure. Q. What are the possible causes of coma with small pupils? [...]
A Spider called Willis
May 15, 2009 By 2 Comments
A ferocious spider lives in the brain. His name is Willis!
More brainstem lesions
May 14, 2009 By 1 Comment
Neurological Mind-boggler 004 Even more scenarios designed to test drive Gates’ Brainstem Rules of 4 (helpful figures here): Scenario 5 You are examining a patient with sudden onset right-sided weakness. These are your clinical examination findings: weakness of the right face, upper and lower limbs. failure of abduction of the left eye. loss of vibration [...]
