Neurodiagnostic Procedures ELECTROENCEPHALOGRAM The electroencephalogram (EEG) is a physiologic monitor of cortical function. It measures electrical activity that is generated in the cerebral cortex and then synchronized and modulated by…

Traumatic Brain Injury Damage to the brain after trauma may be caused by direct injury from bone fragments or penetrating missiles; impact of brain against the base of the skull;…

Increased Intracranial Pressure CASE A 47-year-old man comes to the emergency room after one week of high fever and headache. Today he became progressively weaker on his right side and…

Lumbar Puncture and Cerebrospinal Fluid INDICATIONS When central nervous system (CNS) infection (meningitis, encephalitis) is suspected, one must examine the cerebrospinal fluid (CSF). However, there is an exception: lumbar puncture…

Treatment of Pain in Neurologic Disease A working understanding of pain and its treatment is important in the management of many patients with neurologic disease. Consider the following points: Pain…

Neurology of Other Systemic Diseases CASE A 57-year-old woman complains of weakness when getting out of a chair, and a hoarse voice. She has been losing hair and gaining weight,…

Neurology of Alcoholism CASE The chief executive officer of a small company is admitted for an appendectomy. Two days postsurgery, he experiences two generalized tonic–clonic seizures that occur within 15…

Neurology of Uremia CASE A 64-year-old man with end-stage renal failure tells you that at night his legs “bother him.” Just after he lies down in bed, his legs feel…

AIDS and the Nervous System CASE A 30-year-old woman with hemophilia develops a cough, shortness of breath, and has bilateral lung infiltrates on chest x-ray. She is also confused, with…

Central Nervous System Infections Central nervous system (CNS) infections are suggested by a constellation of signs, symptoms, and laboratory studies. The major groups of CNS infections include: Bacterial meningitis. Viral…