Approach to the Ataxic Patient
(Video 29.1). Upper motor neuron signs (hyperreflexia and spasticity) are commonly found in patients with SCA1 and SCA3; cognitive impairment has been reported in association with SCA2, SCA12, SCA13, and…
Approach to the Hypokinetic Patient
B. Response to medications. Absence of benefit from adequate dosages of dopaminergic drugs, especially levodopa, casts doubt on the diagnosis of IPD and suggests a diagnosis of secondary causes of parkinsonism…
Approach to the Patient with Upper Extremity Pain and Paresthesias and Entrapment Neuropathies
(2) Paresthesias and sensory loss. Paresthesias are spontaneous sensations originating from nerve fibers, which patients describe as “tingling” or “pins and needles.” Sensory loss indicates absence of normal sensation, which patients…
Neurotoxicology
(Video 59.1). d. Treatment. (1) Activated charcoal. 1 g/kg by mouth if the patient is awake and is not at risk of aspiration and if ingestion is within 1 hour. (2) Benzodiazepines. Repeated…
Approach to Ethical Issues in Neurology
Do you believe that the decision to treat Maria with IV morphine 6 months earlier was to hasten her death? Is this an “acceptable” outcome for someone who is 94…
Approach to the Patient with Dysarthria
(Video 19.1). Other findings include muscle weakness with greater than normal tone. Dysphagia may also occur. In addition to spastic dysarthria, the patient with pseudobulbar palsy may often exhibit emotional…
Peripheral Neuropathy
Video 51.1). Significant atrophy can occur in the affected muscles. The pain usually lessens within 3 to 6 weeks. Sensory loss and weakness improve over months, but long-term deficits may…
Approach to the Patient with Acute Muscle Weakness
(see Video 31.1). Eventually, dysarthria, dysphagia, and respiratory distress may occur. Ocular myasthenia will present with asymmetric ptosis and diplopia. There is fatigability induced by repetitive exercise. Muscle tone, bulk,…
Approach to the Patient with Acute Sensory Loss
(Video 27.1). D. Brachial and lumbosacral plexus. Acute sensorimotor deficits indicating multiple nerve or nerve-root distributions in an arm or leg suggest plexopathy. E. Spinal cord. Most fibers conducting pain and temperature…
Approach to the Patient with Lower Extremity Pain, Paresthesias, and Entrapment Neuropathies
FIGURE 25.1 Motor distribution of the nerves of the lower limb. (Modified from Basmajian JV. Grant’s Method of Anatomy. 9th ed. Baltimore, MD: Williams and Wilkins; 1975.) (2) General. Examination or palpation…
