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SPECIFIC OBJECTIVES - DAY 1 - THE NEUROLOGICAL EXAMINATION – The neurologic examination - a relevant, manageable and reproducible diagnostic tool. Clinical tests for specific neurologic functions. A screening neurologic exam for asymptomatic patients. A problem-tailored neurologic exam for patients with neurologic complaints. WAKING UP TO SLEEP DISORDERS – A diagnostic and therapeutic approach to insomnia. Clinical features, associated disorders and treatment of sleep apnea. Clinical features and treatment of narcolepsy and REM-sleep behavior disorder. Clinical features, associated disorders and treatment of restless legs syndrome. NEUROLOGIC EMERGENCIES, PART I – Spinal cord compression, Guillain-Barré Syndrome, Myasthenic Crisis. Approach to examination and diagnosis. Cost-effective testing. Treatment and rehabilitation. NEUROLOGIC EMERGENCIES, PART II – Status epilepticus, coma, and subarachnoid hemorrhage. Pupillomotor function in CNIII Palsies and prognosis. Cost-effective testing. Treatment and rehabilitation. DAY 2 - AN APPROACH TO THE DIZZY PATIENT – Common presentations of dizziness. Pathophysiology of vertigo and nystagmus. Bedside techniques to distinguish dizziness subtypes. Potentially curative treatment for benign positional vertigo. PERIPHERAL NEUROPATHY AND NEUROPATHIC PAIN MANAGEMENT – The spectrum of neuropathic signs, symptoms, and causes. Approach to bedside examination. Mechanism of neuropathic pain. Use of effective medications- nortriptyline, gabapentin, others. SEIZURES AND EPILEPSY – DIAGNOSIS – Major types of seizures. Epidemiologic aspects of epilepsy. Distinguish seizures from other transient neurologic events. Plan for diagnostic investigation. SEIZURES AND EPILEPSY – MANAGEMENT – Anticonvulsant medications. When treatment with anticonvulsant medication is warranted. Status epilepticus. Problems confronted by women with epilepsy. DAY 3 - HEADACHE AND MIGRAINE – Common presentations of various headache disorders. Pathophysiology of headache and migraine. Medication and non-pharmacologic strategies. The prevalence of medication overuse for headaches in daily practice. SYNCOPE: WHICH TEST IS BEST FOR THE FAINTING PATIENT? – Causes and natural history of syncope. Role of bedside tilt and tilt table testing. Treatment strategies for orthostatic hypotension. DRUGS AND THE NERVOUS SYSTEM – Common effects of prescribed drugs on the nervous system. Common effects of illicit drugs on the nervous system. Common neurologic complications of alcoholism. Common neurologic side effects of antidopaminergic medication. MULTIPLE SCLEROSIS – Typical clinical features of multiple sclerosis. Series of diagnostic investigations. Approach to abortive and prophylactic therapy of multiple sclerosis. Common treatable medical complications of multiple sclerosis. DAY 4 - DEMENTIA – Patient with mild cognitive impairment or dementia. Major syndromes associated with common causes of dementia. Therapeutic plan for a patient with dementia. Conditions that frequently mimic dementia. PARKINSON’S DISEASE AND ITS DIFFERENTIAL DIAGNOSIS – Clinical features of the syndrome of parkinsonism. Other important typical features of Parkinson’s disease and clinical features atypical for Parkinson’s disease. Long-term complications of Parkinson’s disease and major treatment options. Common types of tremor and therapeutic plan for a patient with essential tremor. COBALAMIN (B-12) DEFICIENCY AND OTHER DISORDERS OF GASTROINTESTINAL FUNCTION – Advances in recognition of B-12 deficiency and Post-Gastroplasty Neuropathy. Changing clinical presentation of this illness. Newer laboratory techniques to the diagnosis. Diagnosis and treatment. LIBBY ZION’S LESSON: SEROTONIN SYNDROME AND OTHER P450 DRUG INTERACTIONS – Clinical features of a common drug interaction. Features of serotonin syndrome and distinguish from other Neurologic drug toxicities. Potential drug interactions and determine how to predict them. Anticipating and avoiding drug interactions. DAY 5 - STROKE, PART I - RISK FACTORS AND PREVENTION – Risk factors and modification. Principles of localization to classify stroke subtypes. When to refer patients for carotid endarterectomy. Use of aspirin, clopidogrel, dipyridamole, warfarin, heparin and carotid endarterectomy. STROKE, PART II – TIA AND STROKE MANAGEMENT – Define TIA. Protocol for evaluation and treatment of TIA and stroke. Apply inclusion criteria and CT criteria for thrombolysis. Outcomes, hemorrhage rate, recovery. SPASTICITY, ATAXIA AND OTHER MOVEMENT DISORDERS – Major clinical features of spasticity. A diagnostic investigation of cervical spondylosis. Ataxia and the other major clinical features of cerebellar dysfunction. Different types of involuntary movements. PSYCHOGENIC NEUROLOGIC DISORDERS – Most common neurologic manifestations of psychogenic disorders. Distinguish among malingering, factitious disorders and conversion disorders. The major risk factors for psychogenic illness. A plan for management of a psychogenic illness.
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