Nutritional Disorders: Malabsorption, Malnutrition, Vitamin Deficiencies Vitamin B12 (Cobalamin) Deficiency Most common form: pernicious anemia; anemia, neurologic symptoms, atrophy of epithelial covering of tongue. Other causes: tropical sprue, gastric resection,…
Paraneoplastic Syndromes Definition: disorders caused by indirect damage from systemic cancer to central or peripheral nervous system; not due to metastasis. Epidemiology: rare. Any cancer may be associated with paraneoplastic…
Respiratory Support for Neurologic Diseases Most common neurologic indication for ICU: respiratory monitoring and support. Factors predisposing to pulmonary complications and respiratory failure: depressed consciousness; impaired airway due to depressed…
Renal Disease Uremia: symptomatic renal failure. Uremic Encephalopathy Signs: dysarthria, unsteady gait, asterixis, tremor, multifocal myoclonus, obtundation. Day-to-day fluctuation. Also: tetany, restless legs syndrome, meningismus (often with high CSF protein,…
Bone Disease Osteitis Deformans (Paget Disease) Chronic disease of adult skeleton; bowing and irregular flattening of bones. Any or all skeletal bones may be affected; tibia, skull, pelvis most frequent…
Cerebral Complications of Cardiac Surgery Neurologic complications (frequency about 1%): unresponsiveness after surgery, signs of cerebral infarction on awakening, stroke after surgery, dementia without focal signs. Transient encephalopathy after 3%…
Hepatic Disease Hepatic coma: acute hepatic necrosis; fulminant; delirium, convulsions, coma, decerebrate rigidity. Often fatal. Serum ammonia high. Hepatic encephalopathy: usually with chronic liver disease. Failure of liver to detoxify…
Hematologic and Related Diseases Erythrocyte Disorders Sickle-Cell Disease Neurologic disorders with hemoglobin (Hb)-SS, Hb-SC genotypes, or sickle-β-thalassemia syndromes. Stroke 7% to 15% of homozygous children (250 to 400 times higher…
Endocrine Diseases Pituitary Hypopituitarism Common causes: tumors, infection, vascular lesions, trauma. Lesion in pituitary gland, stalk, or hypothalamus. Evaluation: thyroid function tests, prolactin level, assess adrenal reserve (corticotropin [ACTH] stimulation…
Sleep Disorders Sleep Physiology Sleep cycle: sequence of stages 1, 2, 3, 4, followed by the reverse (4, 3, 2), followed by rapid eye movement (REM) period. Typical cycle duration…
