NEUROLOGY STUDY GUIDE

ABSTRACT

 The idea of a book to help neurologists prepare for the oral part of the Neurology Board Examination stemmed from numerous exchanges with colleagues on how they prepared for this important exam. Nobody seemed to have the magic formula to maximize their chances of passing and there were wide disparities of opinion on what they considered the best preparation. Some recommendations were based on often inaccurate impressions, others were the distorted product of their stressful experience while taking the test. On one thing everyone seemed to agree: There is not a single book available that systematically addresses the specifics of this crucially important test.

The task was daunting because the scope of knowledge required to pass the test is as wide as the field of clinical neurology itself. To make it relevant to the experience of the test it was clear that a good preparation needed to be based on practical advice on the technical aspects of the exam as well as on the proper attitude in taking it. Moreover, filling a void in the current neurology literature, an adequate preparation had to be based on cases and their discussion on evidence-based clinical literature.

Although primarily conceived for neurologists preparing for part 2 of the exam, this book intends to provide interesting case-based material to practicing adult and child neurologists, educators, academicians, supervisors, residents, and medical students.

The book is divided into two parts. Part 1 is devoted to practical tips on the exam’s structure, its etiquette, and preparation. Particular emphasis is placed on reasons for failing the exam. Part 2 concerns itself with the adult and pediatric vignettes part of the oral Board. Each vignette is presented in a format similar to the one candidates find at the exam. The case is then comprehensively formulated with a differential diagnosis, most likely diagnosis, and treatment recommendations. Where relevant, potential pitfalls, dos and don’ts, musts and shoulds, and frequently asked questions complement the case discussion.

            

                  Contents

Preface....................................................................................................  v

Part 1 1 General Information ................................................................................     The Candidate ........................................................................................        Presenting Yourself ..............................................................................        The Day You Arrive.............................................................................     The Examiners .......................................................................................        Structure of the Examining Team ...........................................................        Training of Examiners ..........................................................................        How Examiners Plan for the Session.......................................................        Grading .............................................................................................        Your Interaction with the Examiners .......................................................     The Anxiety Factor .................................................................................        Hints for Dealing with Anxiety ..............................................................     Information on the Board .........................................................................

2 The Live Patient Examination ...................................................................   The Room .............................................................................................   The Time Factor: 30-Minute History and Neurological Examination ................   The Tool Box (Your Medical Instruments)...................................................   The Patient ............................................................................................   Differential Diagnosis and Discussion of Treatment Options...........................     Your Interaction with the Patient ............................................................     The Difficult Patient.............................................................................   The 30-Minute Neurological History And Examination..................................     The Art of History Taking .....................................................................     The Neurological Examination ...............................................................   The 30-Minute Case Discussion and Additional Questions .............................

3 The Vignette ..........................................................................................   Adult Vignettes.......................................................................................     How to Approach a Vignette .................................................................     Adult Vignette Topics (Varies) ...............................................................     The Last Ten Minutes...........................................................................     The Candidate Without a Clue ...............................................................   The Pediatric Vignette..............................................................................     Age Categories....................................................................................

4 How to Prepare for the Exam....................................................................   Courses .................................................................................................   Books ...................................................................................................   Practice .................................................................................................

5 Reasons for Failing ................................................................................. 25   A Candidate’s Story ................................................................................ 25

The Safety Factor.................................................................................... The Information Factor ............................................................................ The Differential Diagnosis Factor ..............................................................   Localization of the Lesion .....................................................................   Determining the Temporal Factor ........................................................... Poor Planning and Treatment .................................................................... The Variability Factor ..............................................................................

Part 2  6 Peripheral Nervous System Disorders .........................................................     Motor Neuron Disease .............................................................................        Amyotrophic Lateral Sclerosis ...............................................................        Progressive Muscular Atrophy ...............................................................        Bulbar Palsy .......................................................................................        Kennedy’s Syndrome ...........................................................................     Peripheral Neuropathies ...........................................................................        Guillain-Barre Syndrome ......................................................................´        Chronic Inflammatory Demyelinating Polyradiculoneuropathy.....................        Miller Fisher Syndrome ........................................................................     Disorders of the Neuromuscular Junction ....................................................        Botulism ............................................................................................        Lambert-Eaton Myasthenic Syndrome .....................................................        Myasthenia Gravis ...............................................................................        Brachial Plexopathy .............................................................................        Femoral Neuropathy.............................................................................        Postpartum Plexopathy .........................................................................        Mononeuritis Multiplex ........................................................................     Inflammatory Myopathies.........................................................................        Polymyositis .......................................................................................        Dermatomyositis..................................................................................        Inclusion Body Myositis .......................................................................

7 Cerebrovascular Disorders ........................................................................   Sinus Thrombosis ...................................................................................   Sagittal Sinus Thrombosis ........................................................................   Subarachnoid Hemorrhage........................................................................   Cerebellar Hemorrhage ............................................................................   Cerebal (Lobar) Hemorrhage.....................................................................   Posterior Circulation Disorders ..................................................................     Wallenberg’s Syndrome ........................................................................     Vertebrobasilar Artery Syndrome............................................................     Proximal Basilar Artery Occlusion..........................................................     Posterior Cerebral Artery Infarction ........................................................     Weber’s syndrome ...............................................................................   Carotid Artery Disease.............................................................................   Carotid Artery Dissection .........................................................................   Carotid Cavernous Fistula ........................................................................   Temporal Arteritis ...................................................................................   Stroke Therapy .......................................................................................

Movement Disorders ...............................................................................   Multiple System Atrophy .........................................................................   Progressive Supranuclear Palsy.................................................................. Wilson’s Disease.....................................................................................

Parkinson’s Disease .................................................................................

Dementia with Lewy Bodies ..................................................................... Pick’s Disease and Frontotemporal Dementia ............................................... Huntington’s Disease ...............................................................................

9 Tumors .................................................................................................   Pineal Tumors ........................................................................................   Acoustic Neuroma...................................................................................   Pituitary Adenoma ..................................................................................   Pseudotumor Cerebri ...............................................................................   Limbic Encephalitis.................................................................................   Meningeal Carcinomatosis ........................................................................   Paraneoplastic Cerebellar Degeneration.......................................................   Olfactory Groove Meningioma ..................................................................

Infections .............................................................................................. 97    Herpes Simplex Encephalitis..................................................................... 97    Herpes Zoster Vasculitis ........................................................................... 98    Progressive Multifocal Leukoencephalopathy ............................................... 100    Creutzfeld-Jacob Disease.......................................................................... 101    Lyme Disease......................................................................................... 102    Neurocysticercosis .................................................................................. 104    Cytomegalovirus Polyradiculopathy ........................................................... 105    Parasitic Infections .................................................................................. 106    HTLV-1 Myelopathy ............................................................................... 107

Headache and Facial Pain......................................................................... 111    Painful Ophthalmoplegia .......................................................................... 111    Subdural Hematoma ................................................................................ 113    Migraine Headache ................................................................................. 114    Cluster Headache .................................................................................... 117    Trigeminal Neuralgia ............................................................................... 118    Facial Palsy ........................................................................................... 119

Adult Seizures, Neuro-otology, and Sleep Disorders...................................... 123    New Onset Seizures in Adults ................................................................... 123    Temporal Lobe Epilepsy........................................................................... 124    Status Epilepticus in Adults ...................................................................... 126    Meniere Syndrome .................................................................................. 127    Narcolepsy............................................................................................. 129

Multiple Sclerosis ................................................................................... 133    Multiple Sclerosis ................................................................................... 133    Optic Neuritis......................................................................................... 136    Syringomyelia and Syringobulbia .............................................................. 137    Transverse Myelitis ................................................................................. 139

Neurological Complications of Systemic Disorders ....................................... 141    Wegener’s Granulomatosis........................................................................ 141    Neurological Complications of Rheumatoid Arthritis..................................... 142    Neurological Complications of Malabsorption .............................................. 143    Neuroleptic Malignant Syndrome............................................................... 144    Vitamin B12 Deficiency ............................................................................ 145    Neurological Complications of Diabetes...................................................... 146

Toxic and Metabolic Disorders .................................................................. 149    Wernicke-Korsakoff Syndrome .................................................................. 149    Delirium Tremens ................................................................................... 150    Toxemia of Pregnancy ............................................................................. 150

Pediatric Epilepsy ................................................................................... 153    Neonatal Seizures ................................................................................... 153    Infantile Spasms and Tuberous Sclerosis ..................................................... 155    Absence Seizures .................................................................................... 157    Febrile Seizures ...................................................................................... 159    Juvenile Myoclonic Epilepsy..................................................................... 160    Lennox-Gastaut Syndrome........................................................................ 161    Benign Childhood Epilepsy with Centrotemporal Spikes................................ 163    Status Epilepticus.................................................................................... 164

Pediatric Brain Tumors ............................................................................ 167    Brainstem Glioma ................................................................................... 167

Pediatric Neuromuscular Disorders............................................................. 169    Hypotonic Infant..................................................................................... 169       Spinal Muscular Atrophy Type 1 ............................................................ 171       Spinal Muscular Atrophy Type 2 ............................................................ 171       Spinal Muscular Atrophy Type 3 ............................................................ 171    Muscular Dystrophies .............................................................................. 171       Duchenne’s Muscular Dystrophy ............................................................ 171       Other Muscular Dystrophies .................................................................. 173    Dermatomyositis..................................................................................... 174    Infantile Botulism ................................................................................... 175    Neonatal Transient Myasthenia Gravis ........................................................ 176    Charcot-Marie-Tooth Disease .................................................................... 176    Facioscapulohumeral Muscular Dystrophy................................................... 178    Myotonic Dystrophy................................................................................ 179    Periodic Paralysis.................................................................................... 180    Fabry’s Disease ...................................................................................... 181    Metabolic Myopathies.............................................................................. 182       McArdle’s Disease............................................................................... 182       Acid Maltase Deficiency ....................................................................... 183

Mitochondrial Disorders........................................................................... 187    Mitochondrial Encephalomyopathy ............................................................ 187    Sleep Disorders: Kleine-Levin Syndrome .................................................... 188    Congenital Defects: Mobius’ Syndrome ...................................................... 189

Pediatric Ataxia ...................................................................................... 191    Ataxia-Telangiectasia............................................................................... 191    Friedreich’s Ataxia .................................................................................. 192    Posterior Fossa Tumor as Cause of Chronic Ataxia ....................................... 193    Acute Ataxia .......................................................................................... 194

Pediatric Cerebrovascular Disorders ........................................................... 197    Paradoxical Emboli ................................................................................. 197    Homocystinuria ...................................................................................... 199    Cerebral Hemorrhage............................................................................... 200    Acute Hemiplegia ................................................................................... 201    Subdural Hematoma ................................................................................ 202

Headache............................................................................................... 203   Basilar Migraine.................................................................................. 203   Ophthalmoplegic Migraine .................................................................... 204

Pediatric Neurocutaneous Disorders ........................................................... 207    Neurofibromatosis................................................................................... 207

Pediatric Movement Disorders................................................................... 209    Huntington’s Disease ............................................................................... 209    Sydenham’s Chorea................................................................................. 210    Dystonia Musculorum Deformans .............................................................. 212    Tic Disorders ......................................................................................... 213

Pediatric Neurometabolic Disorders............................................................ 217    Tay-Sachs Disease................................................................................... 217    Krabbe’s Disease .................................................................................... 219    Metachromatic Leukodystrophy................................................................. 220    Neuronal Ceroid Lipofuscinosis................................................................. 221    Adrenoleukodystrophy ............................................................................. 222

Pediatric Infections.................................................................................. 225    Subacute Sclerosing Panencephalitis........................................................... 225    Gradenigo’s Syndrome............................................................................. 226    Neonatal Meningitis ................................................................................ 226

Index .......................................................................................................... 229 HARGA: Rp. 200.000,- DOWNLOAD PESAN