Neurologic clinics
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This article discusses the assessment and management of rapidly progressive weakness due to neuromuscular disorders. The authors review elements helpful in determining the causes of weakness including pertinent history and laboratory studies. ⋯ In addition, respiratory function assessment is reviewed. The latter part of this article is devoted to evaluation and management of two of the most common disorders, Guillain-Barré syndrome and myasthenia gravis.
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Traumatic brain and spinal cord injuries remain the leading cause of death and disability for individuals under 50 years of age. This article describes common causes of primary and secondary central nervous system injuries. Particular emphasis is placed on the initial evaluation of trauma patients, detection of head and spinal cord injuries, and critical care of these patients. Definitive management of central nervous system injuries and prognosis and long-term management issues are also discussed.
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Neurologic emergencies are common among cancer patients and their incidence is increasing as patients live longer as a result of improved antineoplastic therapy. This article reviews acute neurologic complications in cancer patients. Among those complications reviewed are brain metastases, epidural spinal cord compression, leptomeningeal metastases, cerebrovascular disorders, complications of antineoplastic therapy, and paraneoplastic syndromes.
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This article outlines neuro-ophthalmic findings and diseases which may present in an emergency setting. The abnormal optic disc, visual loss, double-vision and disorders of gaze, skew deviation, and the neuro-ophthalmology of vascular lesions, intracerebral hemorrhage, increased intracranial pressure, neuromuscular emergencies, metabolic disturbances, and trauma are all reviewed.
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Coma and confusion signal a failure of brain function with many possible causes. Since many of the potential causes may quickly lead to death or severe disability, it is important to develop a focused and ordered approach to facilitate the rapid diagnosis and early institution of proper therapies. This requires an understanding of the localizing features of the neurologic examination and of the syndromes likely to cause coma and confusion, a predetermined plan for empiric therapies in certain cases of doubt when diagnostic confirmation will be delayed, and a careful consideration of cases when the diagnosis is not revealed by the initial neuroimaging, lumbar puncture, or EEG.