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…
Ménière Syndrome Attacks of vertigo lasting hours to days. Hearing loss, tinnitus occur within attacks early in course; permanent later. Sense of fullness in affected ear often accompanies attacks. Prevalence…
Transient Global Amnesia Sudden inability to form new memory traces (anterograde amnesia) plus retrograde memory loss for preceding days or weeks. Accompanied by bewilderment, anxiety, repeated questions (e.g., “Where am…
Febrile Seizures Generalized seizures with febrile illness (not meningitis or encephalitis). Even if recurrent, do not warrant designation of epilepsy. Usually occur between ages 3 months and 5 years. About…
