Category: Neurology

Lumbar Puncture

A lumbar puncture uses a fine needle inserted between the vertebrae in the lower back to take samples of CSF from the subarachnoid space. The CSF that is obtained can aid the diagnosis of infections, subarachnoid haemorrhage & neurological disorders including Guillan-Barré Syndrome (GBS) or MS. Check out our article on CSF interpretation for more

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Sudden Visual Loss

Loss of vision can be a scary symptom for patients to experience, and a scary presentation for doctors to manage! You will not be expected to know the causes in detail. However, some knowledge of the following conditions will help you to risk-stratify patients. These patients will most likely require an urgent referral to your

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Vertigo

Vertigo is described as an “abnormal sensation of motion. It can occur in the absence of motion or when motion is sensed inaccurately”1 Assessing a patient with vertigo can be challenging, even for experienced clinicians. Patients often use the words “vertigo” and “dizziness” synonymously to describe their symptoms, but the sensations they are experiencing can

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CNS Infections

A CNS infection is one that involves the central nervous system in some way. This includes the meninges, cerebellum, ventricular system and spinal cord, among others. Meningitis is the most common form of CNS infection. You should have a low threshold for starting empirical treatment in suspected cases of meningitis or encephalitis, particularly in patients

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Interpreting CSF Results

Understanding how to do an LP and interpret the results is an essential skill for most doctors, particularly those planning on a hospital-based specialty. You will often be handed over to review the results and act accordingly during ward cover shifts. As with any handover, ensure when you are asked to chase the results that

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Syncope

From the Greek: Syn: together & kopein: to cut – referring to a block in blood supply from the body to the brain, most often due a drop in systemic blood pressure. It is defined as (1) temporary and transient (2) a form of loss of consciousness…

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Parkinson’s Disease

In this article, we will present several common scenarios involving Parkinson’s disease (PD) that you might face on the ward or on call. We will not go into too much detail about the pathophysiology of the disease – as fascinating as it is. This is more of a quick practical guide, on how to deal

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Seizures

Scenario: You are bleeped by one of the staff nurses to review a patient on the orthopaedic ward who is “jerking in her bed”. She tells you the patient is a 74-year-old female who is 2 days post knee replacement. She is a known epileptic who takes sodium valproate daily but has not taken any

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Reduced GCS

As a doctor, you will frequently be called for a drowsy patient. They can vary from confused to completely unconscious. The Glasgow Coma Scale can help reliably quantify and track the level of consciousness over time – however, during the initial assessment, it takes too long unless you use it regularly. You can use AVPU

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Metastatic Spinal Cord Compression

Spinal cord compression occurs when there is compression of the spinal cord or cauda equina at any level secondary to the effects of a malignancy. This can include metastatic infiltration to the vertebral column causing instability or pathological fractures as well as direct pressure from malignancy to the spinal cord. This condition affects around 5-10%

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