Home / Subjects / Neurology

Neurology

The study and treatment of disorders of the nervous system.

βœ“ Introduction to Neurology

βœ“ Introduction to Neurology is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Brain Anatomy Basics

βœ“ Brain Anatomy Basics is an essential biology topic covering living systems, from cellular processes to ecosystems.

Key points: Structure and function, clinical presentation, diagnostic criteria, and evidence-based management.

βœ“ Brain Physiology Basics

βœ“ Brain Physiology Basics is an essential biology topic covering living systems, from cellular processes to ecosystems.

Key points: Structure and function, clinical presentation, diagnostic criteria, and evidence-based management.

βœ“ EEG Basics

βœ“ EEG Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Stroke Basics

βœ“ Stroke Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Epilepsy Basics

βœ“ Epilepsy Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Headache Basics

βœ“ Headache Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neuropathy Basics

βœ“ Neuropathy Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Myopathy Basics

βœ“ Myopathy Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Dementia Basics

βœ“ Dementia Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Parkinson's Basics

βœ“ Parkinson's Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Multiple Sclerosis Basics

βœ“ Multiple Sclerosis Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Meningitis Basics

βœ“ Meningitis Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Encephalitis Basics

βœ“ Encephalitis Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neuro-oncology Basics

βœ“ Neuro-oncology Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neurosurgery Basics

βœ“ Neurosurgery Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neuromuscular Basics

βœ“ Neuromuscular Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neuroimaging Basics

βœ“ Neuroimaging Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neurological Exam Basics

βœ“ Neurological Exam Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neurology Ethics Basics

βœ“ Neurology Ethics Basics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neurology Careers

βœ“ Neurology Careers is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Advanced Neurology

βœ“ Advanced Neurology is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Brain Anatomy

βœ“ Brain Anatomy is an essential biology topic covering living systems, from cellular processes to ecosystems.

Key points: Structure and function, clinical presentation, diagnostic criteria, and evidence-based management.

βœ“ Brain Physiology

βœ“ Brain Physiology is an essential biology topic covering living systems, from cellular processes to ecosystems.

Key points: Structure and function, clinical presentation, diagnostic criteria, and evidence-based management.

βœ“ EEG

βœ“ EEG is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Stroke

βœ“ Stroke is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Epilepsy

βœ“ Epilepsy is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Headache

βœ“ Headache is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neuropathy

βœ“ Neuropathy is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Myopathy

βœ“ Myopathy is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Dementia

βœ“ Dementia is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Parkinson's Disease

βœ“ Parkinson's Disease is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Structure and function, clinical presentation, diagnostic criteria, and evidence-based management.

βœ“ Multiple Sclerosis

βœ“ Multiple Sclerosis is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Meningitis

βœ“ Meningitis is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Encephalitis

βœ“ Encephalitis is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neuro-oncology

βœ“ Neuro-oncology is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neurosurgery

βœ“ Neurosurgery is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neuromuscular

βœ“ Neuromuscular is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neuroimaging

βœ“ Neuroimaging is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neurological Exam

βœ“ Neurological Exam is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neurology Ethics

βœ“ Neurology Ethics is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

βœ“ Neurology Research

βœ“ Neurology Research is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Time complexity (Big-O), space complexity, correctness proof, and practical implementation trade-offs.

βœ“ Neurology Innovation

βœ“ Neurology Innovation is a clinical topic covering pathophysiology, diagnosis, evidence-based treatment, and patient care.

Key points: Core principles, practical applications, and advanced concepts that build deep understanding.

Key Clinical Formulas & Scores

Glasgow Coma Scale (GCS): Eye (1-4) + Verbal (1-5) + Motor (1-6)
Eye: 4=Spontaneous, 3=To speech, 2=To pain, 1=None
Verbal: 5=Oriented, 4=Confused, 3=Inappropriate, 2=Incomprehensible, 1=None
Motor: 6=Obeys commands, 5=Localizes pain, 4=Withdraws, 3=Flexion, 2=Extension, 1=None
Score: 13-15=Mild, 9-12=Moderate, 3-8=Severe (coma)
NIH Stroke Scale (NIHSS): 0-42 points (higher = worse)
1a: Level of consciousness (0-3)
1b: LOC questions (0-2)
1c: LOC commands (0-2)
2: Best gaze (0-2)
3: Visual fields (0-3)
4: Facial palsy (0-3)
5-6: Motor arm/leg (0-4 each)
7: Limb ataxia (0-2)
8: Sensory (0-2)
9: Best language (0-3)
10: Dysarthria (0-2)
11: Extinction/inattention (0-2)
Interpretation: 0=no stroke, 1-4=minor, 5-15=moderate, 16-20=moderate-severe, 21-42=severe
ABCDΒ² Score (TIA Risk Stratification):
A = Age β‰₯60 years (1 pt)
B = BP β‰₯140/90 (1 pt)
C = Clinical features: Unilateral weakness (2), speech impairment (1)
D = Duration: β‰₯60 min (2), 10-59 min (1)
Dβ‚‚ = Diabetes (1 pt)
Score 0-3: Low risk (1.0% 2-day stroke risk)
Score 4-5: Moderate (4.1%)
Score 6-7: High (8.1%)
Modified Rankin Scale (mRS): Disability/Outcome
0 = No symptoms
1 = No significant disability (able to carry out all usual activities)
2 = Slight disability (unable to carry out all previous activities, but able to look after own affairs)
3 = Moderate disability (requires some help, but able to walk unassisted)
4 = Moderately severe disability (unable to walk unassisted, unable to attend to bodily needs)
5 = Severe disability (bedridden, incontinent, requires constant care)
6 = Dead
Intracerebral Hemorrhage (ICH) Score:
β€’ GCS 3-4: 2 points
β€’ GCS 5-12: 1 point
β€’ GCS 13-15: 0
β€’ ICH volume β‰₯30 mL: 1 point
β€’ ICH volume <30 mL: 0
β€’ Intraventricular hemorrhage: Yes=1, No=0
β€’ Infratentorial origin: Yes=1, No=0
β€’ Age β‰₯80: Yes=1, No=0
30-day mortality: 0=13%, 1=26%, 2=72%, 3=97%, 4=100%, 5=100%

Core Concepts

Stroke: Ischemic vs Hemorrhagic

Ischemic (87%): Thrombotic, embolic, or hypoperfusion. CT: hyperdense artery sign, loss of gray-white differentiation, insular ribbon sign. Treatment: IV tPA within 4.5 hours (0.9 mg/kg, max 90mg), mechanical thrombectomy within 6-24 hours (based on DAWN/DEFUSE-3 criteria). Hemorrhagic (13%): hypertensive (basal ganglia, thalamus, pons, cerebellum), aneurysmal SAH, AVM. CT: hyperdense blood. Reverse coagulization, lower SBP <140, neurosurgical evaluation.

Seizure Classification & Management

ILAE 2017: Focal (aware/impaired awareness), Generalized (absence, myoclonic, atonic, tonic-clonic), Unknown. Status epilepticus: seizure >5 min or recurrent without recovery. First-line: lorazepam 0.1 mg/kg IV (max 4mg) or midazolam 10mg IM. Second-line: levetiracetam 60 mg/kg IV or fosphenytoin 20 mg PE/kg. Third-line: propofol or midazolam infusion. Non-convulsive status: continuous EEG monitoring.

Peripheral Neuropathy Patterns

Mononeuropathy: single nerve (carpal tunnel, ulnar neuropathy). Mononeuritis multiplex: multiple nerves, asymmetric (vasculitis, diabetes). Polyneuropathy: distal symmetric stocking-glove (diabetes, B12 deficiency, alcohol, CMT). Radiculopathy: dermatomal (disc herniation, foraminal stenosis). Plexopathy: brachial/lumbosacral (trauma, tumor, radiation). Nerve conduction studies + EMG for localization and characterization.

Headache Classification (ICHD-3)

Primary: Migraine (with/without aura, chronic), Tension-type (infrequent/frequent/chronic), Cluster (episodic/chronic), Trigeminal autonomic cephalalgias. Secondary: SAH ("thunderclap"), temporal arteritis (>50 yrs, ESR↑, jaw claudication), meningitis, IIH (papilledema, LP opening pressure >25 cmHβ‚‚O), medication overuse, post-traumatic. SNOOP4 red flags: Systemic symptoms, Neurologic signs, Onset sudden, Older age (>50), Previous headache history change, Positional, Precipitated by Valsalva, Papilledema, Progressive.

Parkinson Disease & Movement Disorders

PD: TRAP symptoms β€” Tremor (resting 4-6 Hz), Rigidity (cogwheel), Akinesia/Bradykinesia, Postural instability. Pathology: Lewy bodies (Ξ±-synuclein), dopaminergic neuron loss in substantia nigra. Treatment: Levodopa/Carbidopa (gold standard), dopamine agonists (pramipexrole, ropinirole), MAO-B inhibitors (selegiline, rasagiline), COMT inhibitors (entacapone), DBS for advanced disease. Atypical: MSA, PSP, CBD, DLB.

Clinical Case Studies

Case 1: Acute Ischemic Stroke

Patient: 68-year-old male, sudden right-sided weakness and aphasia, last seen normal 2 hours ago. NIHSS = 12. BP 185/100. CT head: no hemorrhage, hyperdense left MCA sign. CT angiography: left M1 occlusion.

Diagnosis: Acute left MCA ischemic stroke, eligible for both IV tPA and mechanical thrombectomy.

Management: IV tPA 81 mg (8.1 mg bolus + 72.9 mg infusion over 1 hour). Mechanical thrombectomy (stent retriever) β€” door-to-puncture time <90 minutes. Post-procedure: aspirin 325mg daily (after 24h if tPA given), statin, dysphagia screen, DVT prophylaxis, stroke unit admission, rehabilitation.

Case 2: Status Epilepticus

Patient: 45-year-old female, witnessed tonic-clonic seizure lasting 8 minutes, not returning to baseline. PMH: epilepsy, non-compliant with levetiracetam. Glucose 95 mg/dL, Na 138, temp 38.2Β°C.

Diagnosis: Convulsive status epilepticus.

Management: Lorazepam 4mg IV Γ— 2 doses. Levetiracetam 60 mg/kg IV load (3000mg). Continuous EEG monitoring. Workup: LP (meningitis/encephalitis?), CT head, labs (CBC, CMP, tox screen, antiepileptic drug levels). If refractory: propofol or midazolam infusion with goal burst suppression on EEG.

Case 3: Subarachnoid Hemorrhage

Patient: 52-year-old female, sudden severe "thunderclap" headache with neck stiffness and photophobia. GCS 14 (E4 V4 M6). CT head: diffuse hyperdensity in basal cisterns and sylvian fissures. Hunt & Hess Grade II.

Diagnosis: Aneurysmal subarachnoid hemorrhage (Fisher Grade 3).

Management: Emergent CTA to identify aneurysm. Neurosurgical consultation for clipping or endovascular coiling. Nimodipine 60mg every 4 hours Γ— 21 days (prevents vasospasm). Maintain euvolemia, avoid hypotension. Transcranial Doppler monitoring for vasospasm. Treat hypertension cautiously (target SBP <160). EVD if hydrocephalus.

Practice Questions

Q1: A patient presents with GCS of 7 (E2 V2 M3). What severity of traumatic brain injury does this indicate?
A: Severe TBI (GCS 3-8). Requires airway protection (intubation), emergent neuroimaging, ICP monitoring, and neurosurgical consultation.
Q2: What is the time window for IV tPA administration in acute ischemic stroke?
A: Within 4.5 hours of last seen normal (with extended window up to 4.5 hours for select patients based on imaging criteria).
Q3: A 60-year-old with atrial fibrillation has an ABCDΒ² score of 5. What is the recommended management?
A: High risk (4.1% 2-day stroke risk). Urgent neurology consultation, MRI brain with DWI, carotid imaging, anticoagulation if confirmed TIA, antiplatelet if not.
Q4: What is the first-line treatment for acute convulsive status epilepticus?
A: Benzodiazepines β€” lorazepam 0.1 mg/kg IV (max 4mg) or midazolam 10mg IM if no IV access.
Q5: A patient with ICH score of 4 has what approximate 30-day mortality?
A: 97-100%. ICH score: GCS 3-4=2, GCS 5-12=1, volume β‰₯30mL=1, IVH=1, infratentorial=1, age β‰₯80=1.

πŸ“š Related Subjects

All Subjects

Categories

Get Premium