Transient Loss of Consciousness

May 3, 2021 by in NEUROLOGY Comments Off on Transient Loss of Consciousness

Dysfunction of either the brainstem or both cerebral hemispheres is necessary for loss of consciousness (LOC) to occur. Syncope, caused by global hypoperfusion of the brain due to a drop…

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Bladder Dysfunction

May 3, 2021 by in NEUROLOGY Comments Off on Bladder Dysfunction

Urinary continence requires coordination of both the somatic and autonomic nervous systems, and also involves elements of volitional control and assessments of social appropriateness. Urinary storage is primarily mediated involuntarily…

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Difficulty Walking

May 3, 2021 by in NEUROLOGY Comments Off on Difficulty Walking

Gait disorders can result from dysfunction of motor coordination systems, pyramidal or extrapyramidal motor pathways, or impairments in proprioceptive sensation. In addition, there are a number of nonneurologic causes of…

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Ataxia

May 3, 2021 by in NEUROLOGY Comments Off on Ataxia

A. Initial evaluation should determine whether ataxia appears sensory or cerebellar. Profoundly decreased sensation and hyporeflexia in the absence of dysarthria or oculomotor findings make sensory ataxia more likely. Nystagmus,…

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Multiple Cranial Neuropathies

May 3, 2021 by in NEUROLOGY Comments Off on Multiple Cranial Neuropathies

Aside from the olfactory cranial nerve (CN I) and the optic nerve (CN II), the remaining cranial nerves (CN III–XII) have nuclei in the brainstem. These then have axons extending…

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Hyperreflexia and Hyporeflexia

May 3, 2021 by in NEUROLOGY Comments Off on Hyperreflexia and Hyporeflexia

The muscle stretch, or “deep tendon,” reflex is the product of a segmental reflex arc involving specific spinal cord or brainstem regions; this makes testing reflexes useful for anatomic localization….

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Sensory Disturbance: Pain and Temperature

May 3, 2021 by in NEUROLOGY Comments Off on Sensory Disturbance: Pain and Temperature

Temperature and pain sensations are conveyed via small myelinated and unmyelinated nerve fibers. These enter the spinal cord via the dorsal spinal root and synapse in the dorsal horn at…

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Fasciculations

May 3, 2021 by in NEUROLOGY Comments Off on Fasciculations

Fasciculations are caused by spontaneous depolarization of lower motor neurons, which results in contraction of the muscle fibers in the associated motor unit. Clinically this manifests as a visible twitch…

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Unilateral Foot Drop

May 3, 2021 by in NEUROLOGY Comments Off on Unilateral Foot Drop

Unilateral foot drop is a common complaint. Careful examination of the anatomical pattern of the weakness helps identify the most likely location of the causative lesion. In some cases, clinical…

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Knee Extension Weakness

May 3, 2021 by in NEUROLOGY Comments Off on Knee Extension Weakness

The quadriceps muscles in the anterior thigh extend the knee and are innervated by the femoral nerve, which arises from the lumbar plexus. The L2, L3, and L4 nerve roots…

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