Clinics in Neurology Alaka Deshpande
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1Clinics in NEUROLOGY2
3Clinics in NEUROLOGY
Alaka Deshpande MBBS MD MAMS FIMSA FICP Formerly Head of the Department of Medicine Grant Medical College Sir JJ Group of Hospitals Mumbai, Maharashtra, India Foreword Devayani Niyogi Udit Dalmia Pradnya Shinde Aditya Prabhudesai
4
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Clinics in Neurology
First Edition: 2014
9789351522171
Printed at
5Dedicated to
My Aai-Baba
&
My Students
6
7FOREWORD
Neurology is a subject read by many but understood by few. It is that treasure trove of knowledge that every student, whether undergraduate or postgraduate, aspires to master but the subject remains as elusive as ever.
Dr Alaka Deshpande is one such teacher who so gracefully untangled the subject of neurology and made it appear so facile and logical. It took one peek into the overfilled lecture theater, the students enraptured, minds churning, the soft smile of realization and wonder on every face to conclude that it was AKD Madam's weekly neurology lecture. It is with the same easy comprehensibility and lucidity, topped with her keen insight into the subject that she has compounded this handbook.
This text provides a step-by-step approach to neurology, starting with the clinical problem, so as to allow a seamless amalgamation of all the information presented in the lengthy tomes on this tricky subject. We, her students from several batches, can unquestionably vouch that these notes have been referred to by generations of her students and have been handed down from batch to batch as a precious legacy—an accurate and lucid key to the enigma called ‘neurology’.
As for Madam, as Robert Frost said, “there are two kinds of teachers: the kind that fill you with so much quail shot that you cannot move, and the kind that just give you a little prod behind and you jump to the skies.” Madam always had the right recipe of how much to reveal, how much to elucidate and what to leave to her eager students to figure out for themselves. It is that sense of wonder that still carries us through this vast ocean, i.e. medicine.
Her passion for teaching, honesty, simplicity and humility made her a role-model!
We are thrilled that students across the nation, who did not have the chance to learn neurology from Dr AKD Madam, will now have access to this book, so she can guide them like she guided us—every step of the way!
Devayani Niyogi
Udit Dalmia
Pradnya Shinde
Aditya Prabhudesai
8
9PREFACE
Clinical neurology beautifully blends the art and science of medicine. Elucidating a detailed history and eliciting the neurological signs is an art, while rationally interpreting the same to arrive at a diagnosis is based on the science of medicine. But the students in general have an unfounded fear for neurology. May be the faculty continues to fill the lectures with inordinate details of neuroanatomy, neurophysiology, neuroradiology and overlook the fact that the student is going to be a clinician and not a neuroscientist. The students find the clinical application of this knowledge difficult.
The philosophy of this book is to facilitate the clinical approach. This is not a textbook of neurology; instead, it will help the bedside approach to a neurological problem. This handbook is designed to give the organized clinical approach starting with general introduction, basic neuroanatomy, pathogenesis, salient features of the disorder, specific laboratory work and the management in brief. The illustrations are few and simple. The language is simple as is used during a bedside clinic.
Over the years, my students have appreciated the clinics. It is on their request that I have penned down this handbook. Hope I have succeeded in this venture. The suggestions from the readers are welcome.
I gratefully acknowledge the constant encouragement from my teachers, particularly Dr RK Gadgil and Dr Sharad Shah. I greatly appreciate the assistance of Dr Shamsher Chauhan, Dr Ameeta Karmarkar and Dr Gaurav Pandey. I am thankful to Shri Anil Upadhyaya for digital assistance.
My father was a teacher. He and my mother made me a conscientious human being!
Teaching is my passion, and students have always inspired me!
I humbly dedicate this book to my parents and my students!
Finally, I am grateful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr Tarun Duneja (Director-Publishing), M/s Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, editors and others, who have helped me a lot to bring out this edition and make my dream come true.
Alaka Deshpande