Video 53.1). In contrast, patients with MG tend not to complain of “generalized weakness,” “generalized fatigue,” “sleepiness,” or muscle pain. In the classic case, fluctuating weakness is worse with exercise…

CLINICAL ASSESSMENT HISTORY A thorough history is the most important element in the evaluation of a patient with chronic or recurrent headache. Temporal profiling assessing frequency and duration of headaches…

FIGURE 12.1 The three-step test in a patient with a right fourth nerve palsy. Note the right hypertropia is greater on left gaze and with right head tilt. Step 2. Record…

2.  Secondary hypokalemic periodic paralysis. a.  Thyrotoxic periodic paralysis occurs 70 times more often in men than in women, despite the increased prevalence of hyperthyroidism among women. In nearly all cases, the…

(Video 23.1) B.  Physical examination. 1.  Acute low back pain. Examination of a patient with acute low back pain should begin with inspection and palpation of the low back. Paravertebral muscle spasms…

2.  Pediatric guidelines for brain death were first published in 1987 and again revised in 2011 by the American Academy of Pediatrics (AAP) and the Child Neurology Society (CNS). The guidelines…

(Video 17.1). If any of these symptoms are present, a detailed characterization is performed. The clinical significance of hearing loss is related to the time and acuity of onset, severity,…

INCIDENCE AND PREVALENCE Inborn errors of metabolism are individually rare. Most data in the past have relied on studies of prevalence, which are highly dependent on ascertainment of cases. This…

A.  Neurally mediated syncope, also referred to as neurocardiogenic, reflex, or vasodepressor syncope, is common and results from the activation of a reflex that produces a significant vasodilatory (vasodepressor) and/or bradycardic…

A.  In cases of immediate failure, the patients never improve after surgery. This universally implies an error in diagnosis or a technical deficiency with the surgery. After the protocol outlined in…