Practice Pearls in Neurology AV Srinivasan, D Vasudevan, Bhanu Kesavamurthy
INDEX
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table.
A
Abductor digiti minimi 65
Abductor pollicis brevis 65
Abscess 83
Acetaminophen 74
Acetazolamide allergy spironolactone 22
Activated partial thromboplastin time 7577
Addison disease 16
Adenovirus 57
Akathisia 94
Akinesia 92
complete 111f
total 110
Alcohol intake 106
Alfa amino-3-hydroxy-5 methyl-4 isoxazole propionic acid receptor 103
Alport syndrome 2
Alzheimer's disease 35, 128
Amaurosis fugax 9
American Academy of Neurology 52, 59
American Heart Association 70
American Stroke Association 70
Amiodarone 14, 16, 74
Anemia 3
correction of 5
Angle-closure glaucoma 10
Ankle jerks, absence of 5
Anterior ischemic optic neuropathy 9
Anticholinergics 106
Anticoagulant 67, 67t
therapy 72, 77t
Anticoagulation
after intracranial hemorrhage, initiation of 78
history of 67
Anticonvulsants 74
Anticonvulsive medications 51
Antiphospholipid antibody syndrome 16, 61
Anxiety 94, 106, 116, 120, 128
physiological tremor of 91
Apixaban 67, 74, 75, 77
Apomorphine 118
infusion, continuous subcutaneous 116, 118, 120, 121
Applause sign 125
Argatroban 67
Arm swing, reduced 106
Aromatic amino acid decarboxylase 95
Arrhythmia, cardiac 6, 53, 106
Arterioles 13
Arteriovenous fistula 6
Arteritic anterior ischemic optic neuropathy 11
Aspiration 83
Ataxia 2, 124
spinocerebellar 83
Atherosclerotic disease 69
Atrial fibrillation 68, 74t, 77
Atrophy, multisystem 91, 110
Auditory cues 112
Auditory nerve 17
Autoimmune disorders 59
Autoregulation failure 2
Azole antifungals 74
Azotemia 2
B
Baclofen 53
Balloon compression 54
Barium swallow test, modified 85
Bartter syndrome 2
Basal ganglia 108
diseases 83
opacification of 2
Basilar transient ischemic attack 11
Behcet's disease 16, 71
Bell's palsy 5659
pathogenesis of 57
Bell's phenomenon 58
Benzodiazepines 128
Beta blockers 24
Biceps brachii 65
Bivalirudin 67
Bleeding 72
anticoagulant-induced 78
intracranial 78
Blindness, transient cortical 11
Blood
columns, segmentation of 13
pressure, uncontrolled 2
Body mass index 22, 23, 25
Bone, temporal 59
Botulinum toxin A 54
Botulism 83
Brachial plexopathies 62, 65, 66
treatment of 65
Brachial plexus 62, 63
anatomic divisions of 63f
anatomy of 62
electrodiagnostic of 64, 65
elements 64
function of 62
injury 66
lesions, classification of 64
MRI of 65
Bradykinesia 91, 106, 108, 123, 127
Brain, chronic vascular disease of 123
Brainstem encephalitis 83
Branch retinal artery occlusion 8, 12
Bruch's membrane 12, 29
C
Calcineurin inhibitors 74
Calcium 2
deposits, presence of 10
Carbamazepine 52, 53, 74
mechanism of action of 52
Carbidopa 96
formulations 116
Carbon monoxide intoxication 110
Carotid 12
occlusion 7
Carpal tunnel syndrome 46
Catechol-O-methyltransferase 101, 102, 116, 117, 121
inhibitors 103
Central nervous system 1, 8
hemangioblastomas 2
Central retinal
artery occlusion 8, 9, 12
vein occlusion 8, 9, 13
Cerebellar
ataxia 2
predominant 123, 126
dysfunction 95
Cerebellopontine angle tumors 59
Cerebral
edema 2
hypoperfusion 11
palsy 83
vein 71
venous thrombosis 70, 71
Cerebrospinal fluid 15, 19, 22, 23, 34f
hypotension 2
pressure 21
studies 10
shunting 24
Cerebrovascular disease 3
Cervical
auscultation 85, 86
paraspinals 65
Challenging disorder 100
Charcot-Marie-tooth disease 83
Chemical cricopharyngeal myotomy 88
Chloroquine 14
Cimetidine 74
Ciprofloxacin 74
Clarithromycin 74
Color vision 7
Coma 3
Compound muscle action potential 62
Computer-assisted static perimetry 18
Conjunctival injection 52
Connective tissue disorders 7
Constipation 94
Continuous dopaminergic stimulation 115, 116, 121
rationale for 115
strategies 120t
Cortical blindness 10
Corticobasal degeneration 83, 91, 110, 123, 126
Corticobasal syndrome 126
Corticosteroids 16, 24
role of 24
Coxsackie virus 57
Cranial nerve 19
palsies 17
C-reactive protein 21, 71
Cricopharyngeal myotomy 88
Cryptococcal meningitis 59
Cyclosporine 16, 83
chemotherapeutic drugs like 11
Cytochrome 53
Cytokine production 2
Cytomegalovirus 3, 57
D
Dabigatran 67, 74, 75, 77
Daily living scale, activities of 118
Decompression, microvascular 54
Deep brain stimulation 101, 103, 117, 120, 121
surgery 116
Dementia 1, 3, 110, 127
Dengue 3
Depression 94, 106, 116, 120, 128
Device assisted therapy 116
Diabetes 7
mellitus 12f, 68
Dialysis
adequate 5, 6
dementia 3
disequilibrium syndrome 1, 2
Digoxin 14
Diphasic dyskinesia 100, 101
Diphtheria 83
Diplopia 17
Disability-adjusted life years 68
Disk
edema 9, 16, 34f
margins, blurring of 11f, 12f
Distal nerve transfers 66
Distal renal tubular acidosis 2
Distal tubular disorders 2
Dolichoectasia 2
Dominant optic
atrophy 14, 35
neuropathy 39f
Dopamine 100, 112
agonist 97, 115, 116, 125
receptor, antagonist of 53
transporter imaging 128
Dopaminergic
agonists 5
denervation 100
loss 38
Dorsal mesencephalon lesions 110
Drenching sweats 94
Dronedarone 74
Drug
interactions 73
toxicity 40
Dural sinus thrombosis 71
Dysautonomia 124, 127
Dyskinesia 100, 101, 106, 120
biphasic 116
drug-induced 96
types of 100
Dyslipidemia 68
Dysphagia 8285, 120, 124
evaluation of 85, 85b
localization of 83
management of 86
mechanical 82
neurogenic 82, 86, 88
oropharyngeal 82
Dyspnea 94
E
Edema, orofacial 59
Edoxaban 67, 74, 75
Elbow joints 92
Electrocardiogram 69
Electroencephalography 1
Electrolyte disturbances 2
Electrophysiological test 58
Electrophysiology 52
Empty sella 19
Encephalopathy 1, 2
hypertensive 3, 11
types of 2t
Endocrine disorders 16
Endoscopy 85
Entacapone 117
Epistaxis 87
Epstein-Barr virus 57
Ernest syndrome 52
Erythromycin 74
Erythropoietin 5, 6
Esophageal function 86
Esophageal manometry 85
Ethambutol 14
toxicity 41
European Federation of Neurological Sciences 52
European Heart Rhythm Association Guidelines 76
European Society of Anesthesiology Guidelines 76
Exercise programs 5
Expanded disability status scale 29
Extensor indicis proprius 65
Extracranial vascular disease 71
Extraplexal repair 66
Eye
care 59
movement abnormalities 106
F
Fabry disease 2
Facial nerve 17, 56
anatomy of 56, 57f
function of 56
grading scale 59
motor component of 56
schwannoma 59
Facial palsy 59, 59t
bilateral 59
peripheral 59
recurrent 59
serenity of 59
syndromes 59
Facial reanimation 61
Falls 104, 105
causes of 104, 105fc
management of 109fc
mechanism of 105
treatment of 108
types of 104
Fatigue 94
Fever 59
Fibrates 74
First dorsal interosseus 65
Fissured tongue 59
Fistula banding, immediate 6
Flexor pollicis longus 65
Fluconazole 74
Fluctuations, types of 116t
Flunarizine 24
Fluorescein angiography 8, 11
Fluvastatin 74
Fluvoxamine 74
Foix-Chavany-Marie syndrome 83
Fondaparinux 75, 76
prophylaxis 77
therapeutic 77
Forearm
radial side of 62
ulnar side of 62
Foveal avascular zone 40f
Free functional muscle transfer 66
Freezing 104
assessment 110
circumstances of 108
severity of 110
subtypes of 110
Frisén scale 17
modified 33
Frontal lobe lesions 110
G
Gabapentin 53
Gait 106, 120
definite freezing of 111
disorder 93, 127
freezing of 106, 108, 109, 110b, 112, 113fc
primary progressive freezing of 110
probable freezing of 112
Gamma-aminobutyric acid receptors 52
Ganglion cell
complex 28, 37f, 46f
thinning 30, 42f
inner plexiform layer analysis 39f
Gasserian ganglion, percutaneous rhizotomy of 54
Gastrointestinal symptoms 120
Gastrostomy tube 87
Gitelman syndrome 2
Globus pallidus interna 103, 117
Glomerular diseases 2
Glycerol injection 54
Goldman's automated kinetic perimetry 8
Goldman's kinetic perimetry 18
Goldman's perimetry testing charts 8
Guillain–Barre syndrome 59, 83
H
Hallucinations 94
Hand
paresthesia and numbness 6
fifth finger and ulnar side of 62
Hantavirus 3
Hartnup disease 2
Headache 10, 16, 17, 19, 24
disorders, International classification of 19
management of 22
sudden onset of 13
therapies 23
Heart failure, congestive 70
Heerfordt–Waldenstrom syndrome 59
Helicobacter pylori 96
Hemianopia, right homonymous 13f
Hemodialysis 2
Hemorrhage, subdural 2
Heparin, unfractionated 67, 71, 7577
Herpes simplex virus 1 57
Hollenhorst plaques 12
Holter monitoring 69
Homonymous hemianopic scotomas 13
Horner's syndrome 64
Hot cross bun sign 124, 124f
House–Brackmann's grading 59, 60t
Human immunodeficiency virus 3, 59, 74
infection 16
protease inhibitors 74
Hummingbird sign 126, 126f
Humphrey's automated static perimetry 8
Huntington's disease 40, 123
Hydrocephalus, normal pressure 93, 110
Hypercoagulable states 7, 71
Hyperhidrosis 120
Hyperhomocysteinemia 3, 71
Hyperkalemia 1, 4
Hyperparathyroidism 5
Hypertension 7, 68, 72
benign intracranial 15
Hyperviscosity 11
Hypokinesia 116
early morning 116
nocturnal 116
postprandial 116
Hypokinetic ventricles 69
Hyponatremia 53
Hypoparathyroidism 16
Hypoperfusion, choroidal 11
Hypotension
intradialytic 6
postural 6, 106
symptomatic intradialytic 6
systemic 11
Hypotonia 2
neonatal 2
I
Idiopathic intracranial hypertension 15, 16t, 19, 20f, 22, 25t, 26, 33, 34f
diagnostic criteria 19t
management in pregnancy 25
symptoms of 17t
treatment of 21
Impotence 6
Impulse control disorder 117, 119, 120
Inflammatory myopathies 83
Influenza B 57
Infraclavicular plexopathies 64
International Headache Society 51
International Normalized Ratio 74, 75, 77
Intracranial pressure 23
Intrajejunal feeding 87
Intraplexal repair 66
Isoniazid 74
Itraconazole 74
J
Japanese B encephalitis 94
Joubert's syndrome 2
Jugular vein obstruction 16
K
Ketoconazole 74
Kidney disease, chronic 1, 3, 4b, 5t, 79
L
Lactation 79
Lambert-Eaton syndrome 83
Lamotrigine 53
L-carnitine 6
Leber's hereditary optic neuropathy 14, 35, 39f
Left ventricular ejection fraction 70
Legs, observable motion of 111f
Leptomeningeal carcinomatosis 59
Levodopa 5, 96, 98, 102, 116
administration 96
carbidopa intestinal gel 101, 120, 121
infusion 116118
high dose 106
induced dyskinesia 100, 101f, 103
consequences of 100
developing 102f
prevention of 102
treatment of 102
types of 101t
Levonorgestrel 16
Levothyroxine 16
Lewy bodies 110, 127
Light source, wavelength of 27
Limb girdle 83
Linezolid 14
Lithium carbonate 16
Liver function, abnormal 72
Local steroid injection 6
Loop of Henle disease 2
Lovastatin 74
Lowe syndrome 2
Lower limbs, proximal muscle weakness of 6
Low-molecular-weight heparin 67, 76, 77
Lumbar puncture 20, 77
Lumboperitoneal shunt 24
Lyme disease 16, 59
Lymphoma 59
M
Macrolides 74
Macular degeneration 12
Macular edema, fingolimod-associated 41
Macular hole 12
Maculopathy 12
Magnesium 2
Magnetic resonance
imaging 22, 52, 58, 62, 95
brain 10, 13f, 124
venography 20f, 22
Malaria 3
Manometry, pharyngeal 85
Marfan syndrome 7
Mass lesions 83
Maxillary nerve 51
Melkersson-Rosenthal syndrome 59
Meningeal hydrops 15
Meningitis, serous 15
Mental status 10
Methylated spirit, vision post-consumption of 42f
Methylene tetrahydrofolate reductase 71
Metronidazole 74
Midodrine 6
Migraine 10, 24, 40, 40f
acephalgic 10
Miller Fisher variant 83
Minimal cognitive impairment 93, 94
Mitochondrial myopathies 83
Monoamine oxidase 113, 116, 121
B 101
inhibitors 97
Motor fluctuations 116
Motor neuron diseases 83
Movement disorders 4
Multiple system atrophy 83, 123, 124, 124f
Muscle 63
biopsy 5
weakness, intermittent 2
Muscular dystrophies 83
Myasthenia gravis 83
Mycobacteria 3
Myelinolysis, central pontine 83
Myoclonus 127
Myotomes 63
N
Nalidixic acid 16
Nascent units 62
Nasogastric tube feeding 87
Nausea 119
Near fall 104
Needle electrode examination 64, 65
Needle electromyography 62
Neovascularization, choroidal 12
Nephrotic syndrome 71
Nerve 63
conduction study 65
Nervous system 1, 2t
Neuroacanthocytosis 83
Neurodegenerative diseases 35
Neurodegenerative disorder 115
Neurological disorders 5t
Neurological dysfunction 1
Neurology 27
Neuroma, acoustic 59
Neuromuscular junction
anomalies of 2
disorders 83
Neuromyelitis optica 7, 29
Neuropathic pain therapy 5
Neuropathy 106
autonomic 46, 83
ischemic monomelic 4, 6
paraneoplastic 83
peripheral 2
Neurotoxins, accumulation of 2
Neurovascular stenting 24
Newer oral anticoagulants 76, 77
Nocturia 106
Nondopamine therapy 103
Nonmotor fluctuations 116
Nonmotor symptoms scale 118
Nonsteroidal anti-inflammatory drugs 23, 74
Normal ganglion cell complex 32, 32f, 34f
Norplant 16
Nutrition, adequate 6
Nystagmus 2
O
Obesity 16
Obstructive sleep apnea 16
Oculomotor 17
dysfunction, predominant 126
Off-period dystonia 101
Olivopontocerebellar atrophy 123
Opercular infarct, bilateral 83
Ophthalmoscope 8
Opioids 23
Optic
atrophy 1 14
disk 35f, 39f
drusen 10, 27, 29
Frisen 18f
head 11
nerve 19
dysfunction, unilateral 8
glioma post-cyberknife radiotherapy 38f
head 30, 32, 34, 37, 38, 42
involvement 7
lesions, hereditary 7
sheath complex 20
neuritis 8, 11
acute 11f
atypical 32f
recurrent 30f
neuropathy 12
compressive 34
ischemic 11
nonarteritic anterior ischemic 12f, 41
posterior ischemic 9
tract lesions 8
Optical coherence tomography 25, 27, 28f, 29, 48
angiography 40
role of 2729, 34, 35
Oral anticoagulants 68f, 74t, 75t
dose 74t
Oral care 60
Oral cavity, disease of 86
Oral medications 116
Orthostatic hypotension 94
management of 125
Oscillopsia 7
Osteoporosis 106
Outer retina, bilateral progressive degeneration of 12
Oxcarbazepine 53
P
Pachymeningitis, malignant 59
Pain 116, 120
diffuse 94
retrobulbar 17
Palpitation 116
Papilledema 17, 18f, 19, 26, 29
asymmetric 17
grade of 25, 25t
true 29
Paralysis
periodic 2
total 60
Parenchymal disease 2
Paresthesia 116
Parkinson's disease 38, 84, 85t, 90, 100, 102, 102f, 104106, 106t, 108110, 115, 119, 121
advanced 116t
early 90, 94, 94t, 95
fall risk assessment 106
idiopathic 124
Parkinson's plus syndromes 93, 123, 128
Parkinson's progression markers initiative 93
Parkinsonism, drug-induced 91, 93, 110
Parotid
enlargement 59
gland tumor 59
Patent foramen ovale 69
Peak dose dyskinesia 100102, 116
Pectoral nerves 64
Percutaneous endoscopic gastrostomy 87
tube 118
Perioptic subarachnoid space, distension of 19
Peripheral nervous system 1
Peritoneal dialysis 2
Phenothiazines 14
Phenytoin 74
Phobia 98
Phosphorus 2
Photopsia 17
Photostress test 12
Pierson syndrome 2
Pimozide 53
Pituitary apoplexy 13
Platelet-rich thrombus 69
Plexopathy 62
diagnosis of 62
traumatic 66
Pneumothorax 87
Poliomyelitis 83
Polycystic kidney disease 2, 4
Polycystic ovary syndrome 16
Polymorphin 100
Polyneuropathy 4
chronic inflammatory demyelinating 4
length-dependent 4
Polypharmacy 106
Positron emission tomography 126
studies 82
Posterior reversible encephalopathy syndrome 2, 3, 911
Postural instability 93, 106
Posture 106
Potassium restriction 5
Pramipexole 116
Preeclampsia 11
Pregabalin 54
Pregnancy 79
Prelaminar optic nerve
gadolinium enhancement of 20
intraocular protrusion of 20
Primary open-angle glaucoma 13
Pronator teres 65
Prothrombin complex concentrate 75
Prothrombin time 75, 76
Pseudoisochromatic color plates 7
Pseudopapilledema 29
Pseudotumor cerebri 15
Psychomotor delay 2
Pulse-synchronous tinnitus 16, 17
Pupil 8
size 45
Q
Quinolones 74
R
Rabies 83
Radio ulnar joints, proximal 92
Radiofrequency rhizotomy 54
Radiosurgery 55
Raised intracranial
pressure 34f
tension 15
Ramsay Hunt syndrome 59
Randomized controlled trial 118
Rapid eye movement 95, 129
behavioral disorder 94
Rasagiline 116
Reflex swallowing 82
Renal disease 1, 2
neurological manifestations of 1
Renal failure 3
Renal function, abnormal 72
Renal transplantation 5, 6
erythropoietin 5
Renal tubular acidosis, proximal 2
Restless legs 5
syndrome 4
Retina
anomalies of 2
cross-sectional images of 28f
Retinal detachment 13
large 8
Retinal migraine 10
Retinal nerve fiber layer 28, 29, 34f, 37f, 48
loss, bilateral 39f
thickness 38f, 42f, 45f
Retinal pigment epithelium 29
Retinal toxins 14
Retinoic acid 16
Retinopathy, central serous 12
Rhythmical tones 112
Rickettsia 3
Rifampicin 74
Rivaroxaban 74, 75, 77
Ropinirole 5, 116
Rosenbaum's card 7
Rotigotine patch 116
Rotigotine transdermal preparation 119
Rubella 57
S
Saccular cerebral aneurysms 2
Safinamide 116
Sarcoidosis 16, 59
Schwannoma 59
Sclera flattening, posterior 20
Scleroderma 83
Sclerosis
amyotrophic lateral 84
multiple 7, 28, 83
Seborrhea 94
Seizures 2, 3, 10
Selective serotonin reuptake inhibitors 74, 127
Selegiline 116
Sensorineural hearing
impairment, progressive symmetric 2
loss 2
Sensory 62
loss 5
nerve
action potential 62
conduction study 64
Serial lumbar punctures 24
Serotonin norepinephrine reuptake inhibitors 74
Sexual dysfunction 94
Short-lasting unilateral neuralgiform headache attacks 52
Shoulder
arthrodesis 66
stabilize 66
Sick-sinus syndrome 69
Sildenafil 6
Sjögren's syndrome 59
Sleep 120
apnea
evaluation of 21
treatment of 21
behavior disorder 127
fragmentation 94
Slit-lamp examination 8
Small fiber peripheral neuropathy 2
Snellen's chart 7
Sodium 2
Spectral domain optical coherence tomography 27, 27t
Sphincter function, loss of 60
Splinting 6
Steven-Johnson syndrome 53
Stiff-Man syndrome 83
Stroke 3, 59, 68, 72, 74t, 83
acute ischemic 69
cryptogenic 69
embolic 69
hemispheric 83
ischemic 69, 72
occipital lobe 13
risk stratification 70
Stylomandibular ligament 52
Subretinal fluid accumulation 33
Sub-Saharan African population 97
Substantia nigra 38
pars compacta 102
Subthalamic nucleus 103, 113, 117
deep brain stimulation of 112
Suicide risk 120
Sulfa antibiotics 16
Sunny brook system 59
Superior vena cava syndrome 16
Supraclavicular brachial plexus injury 64
Supranuclear palsy, progressive 91, 110, 123, 125, 126
Swallowing 82, 120
duration 85
normal 82
parameters 85, 85t
speed 85
therapy 88
volume 85
Sweating 116
Swinging flash light test 8
Synkinesis 60
Syringobulbia 2, 83
Syringomyelia 2
Systemic lupus erythematosus 16
T
Tachycardia 116
Tactile cues 112
Tamoxifen 74
Tardive dyskinesia 83
Temporomandibular joint disorder 52
Tendinitis, temporal 52
Tetanus 83
Tetracycline 16
Thiamine deficiency 2
Three-ounce water swallow test 85
Thrombin inhibitors 67
Thrombocytopenia, heparin-induced 71
Thromboembolism 11
Thyroid hormones 74
Tic douloureux 51, 52
Time domain optical coherence tomography 27
Timed swallowing tests 85
Timed up and go test 107, 107f
Tingling sensation 94
Titonavir 74
Tolcapone 117
Topiramate 22, 24
Tramadol 74
Transcranial sonography 94
Transient ischemic attack 9, 11, 69, 70, 93
management of 78
Transient visual obscuration 9, 16, 17
Transverse venous sinus stenosis 19
Trapezius transfer 66
Trauma 11
Traumatic brachial plexus injury 66
Tremor
essential 90
overflow 90
reduction 120
therapeutic response of 91
Triamterene 22
Triceps brachii 65
Trigeminal nerve 17
Trigeminal neuralgia 51, 52
Trimetho prim-sulfamethoxazole 74
Trochlear nerve palsy 17
Tube feeding 87
Tuberculosis 3, 59
Tubular disease, proximal 2
Tumor
metastatic 83
orbital 10
primary 83
Turner syndrome 16
U
Uhthoff phenomenon 10
Unified Parkinson disease rating scale 105, 117
Upper esophageal sphincter 84
Upper plexus lesions 64
Urea 2
Uremic encephalopathy 1, 2, 4
Uremic myopathy 5, 6
Uremic neuropathy 4
length-dependent 5
prevalence rates of 4
Urinary symptoms 120
Urinary urgency 116
Usual gait speed test 107, 107f
Uveitis, anterior 59
V
Varicella-zoster virus 3, 59
Vascular lesions 7
Vasculitis 7, 11, 59
Ventriculoperitoneal shunt 24
Verapamil 74
Vermian hypoplasia 2
Vertigo 106
Vesicular rashes 59
Vestibulocochlear nerve 56
Videoendoscopy 86
pharyngeal 85
Videofluoroscopy 85, 86, 88
Videomanofluorometry 85
Vigabatrin 14
Vincristine 83
Vision loss 7, 10, 11, 14
acute onset 12f
painful 11f
bilateral 11, 13
painful 32f
history of 7
painful 7
persistent
binocular 13
monocular 11
progression of 11
transient 9fc, 10
binocular 11
monocular 9
Visual acuity 7, 34f
Visual cues 112
Visual evaluation 18
Visual evoked potential 9
Visual field 25t
assessment 18
charting 8
defect 11
examination 10
loss 18
status 25
testing 8
Visual loss 13, 14, 17
persistent 9fc
Vitamin
A related compounds 16
B12 118
deficiency 41
K 73t, 78
antagonist 67, 68, 76
content 73
supplementation 5
von Hippel-Lindau disease 2
W
Weak thumb abduction 6
Wegener's granulomatosis 59
Weight reduction 21
Wernicke encephalopathy 2
Wilson's disease 123
Wrist
arthrodesis 66
joint 92
Z
Zafirlukast 74
×
Chapter Notes

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Practice Pearls in NEUROLOGY
Practice Pearls in NEUROLOGY
Series III
Editors Bhanu Kesavamurthy DNB DM FMMC FRCP Director of Neurosciences, Mehta's Hospital Pvt. Ltd. Chennai, Tamil Nadu, India Former Director Institute of Neurology, Madras Medical College and Government General Hospital Chennai, Tamil Nadu, India D Vasudevan MD DM Professor and Head Department of Neurology Saveetha Medical College Chennai, Tamil Nadu, India Senior Consultant Neurologist The Brain, Spine and Nerve Center Chennai, Tamil Nadu, India AV Srinivasan MD DM PhD FAAN FIAN DSc (Hon) FRCP (Lon) Emeritus Professor The Tamil Nadu Dr MGR Medical University Former Head and Professor of Neurology Institute of Neurology, Madras Medical College Chennai, Tamil Nadu, India Foreword CU Velmurugendran
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Practice Pearls in Neurology—Series III / Bhanu Kesavamurthy, D Vasudevan, AV Srinivasan
First Edition: 2020
9789389188509
Printed at
Dedicated to
Our parents who made us good human beings.
Our teachers who have guided us to become excellent neurophysicians.
Our students and patients who made everything worthwhile.
CONTRIBUTORS
EDITORS
  • Bhanu Kesavamurthy DNB DM FMMC FRCP
  • Director of Neurosciences, Mehta's Hospital Pvt. Ltd.
  • Chennai, Tamil Nadu, India
  • Former Director
  • Institute of Neurology, Madras Medical College and
  • Government General Hospital
  • Chennai, Tamil Nadu, India
  • D Vasudevan MD DM
  • Professor and Head
  • Department of Neurology
  • Saveetha Medical College
  • Chennai, Tamil Nadu, India
  • Senior Consultant Neurologist
  • The Brain, Spine and Nerve Center
  • Chennai, Tamil Nadu, India
  • AV Srinivasan MD DM PhD FAAN FIAN DSc (Hon) FRCP (Lon)
  • Emeritus Professor
  • The Tamil Nadu Dr MGR Medical University
  • Former Head and Professor of Neurology
  • Institute of Neurology, Madras Medical College
  • Chennai, Tamil Nadu, India
CONTRIBUTING AUTHORS
  • Ambika Selvakumar MBBS DO DNB FMRF
  • Director, Department of
  • Neuro Ophthalmology
  • Sankara Nethralaya, A Unit of Medical Research Foundation
  • Chennai, Tamil Nadu, India
  • Anil Venkatachalam MD DM
  • Consultant Neurologist and Movement Disorders Specialist
  • Nanavati Hospital
  • Mumbai, Maharashtra, India
  • Anusha Doraiswamy MD DM DNB
  • Consultant Neurologist
  • MD Neuro Clinic
  • Chennai, Tamil Nadu, India
  • Balasubramanian Samivel MBBS MD DM
  • Professor
  • Department of Neurology
  • Institute of Neurology
  • Madras Medical College
  • Chennai, Tamil Nadu, India
  • Chandramouleeswaran Venkatraman MBBS MD DM
  • Professor
  • Department of Neurology
  • Institute of Neurology
  • Madras Medical College
  • Chennai, Tamil Nadu, India
  • Dipali Nemade MD MPH
  • Department of Neurology
  • Marshall University School of Medicine
  • Huntington, West Virginia, USA
  • Ebin Siby Pharm D
  • Research Scholar
  • Coimbatore, India
  • Harish Jayakumar MD
  • MRCP (UK) DM FEBN
  • Consultant Neurologist
  • JK Institute of Neurology
  • Madurai, Tamil Nadu, India
  • Jawahar Marimuthu MBBS MD DM
  • Professor
  • Department of Neurology
  • Institute of Neurology
  • Madras Medical College
  • Chennai, Tamil Nadu, India
  • Jayasankar VR MBBS MD
  • Senior Resident in Neurology
  • Thrissur, Kerala, India
  • Kala Venkiteswaran PhD
  • Assistant Professor
  • Department of Neurology
  • Penn State College of Medicine
  • Hershey, PA, USA
  • Swetha Komma MBBS DO DNB
  • Fellow in Neuro Ophthalmology
  • Sankara Nethralaya
  • Chennai, Tamil Nadu, India
  • Philo Hazeena MD DM
  • Assistant Professor
  • Department of Neurology
  • Sri Ramachandra Medical College and Research Institute
  • Chennai, Tamil Nadu, India
  • Pranesh Bheemarao Madakasira MD DM
  • MRCP (London)
  • PSG Institute of Medical Sciences and Research
  • Coimbatore, Tamil Nadu, India
  • Senthilnathan MD DM
  • Consultant Neurologist
  • Fortis Malar Hospital
  • Chennai, Tamil Nadu, India
  • Shameer Palliyali MBBS MD
  • Senior Resident in Neurology
  • Malappuram, Kerala, India
  • S Saravanan MD DM
  • Professor
  • Department of Neurology
  • Tirunelveli Medical College
  • Tirunelveli, Tamil Nadu, India
  • Thangaraj M MBBS MD DM
  • Professor and HOD
  • Department of Neurology
  • Government Thanjavur Medical College
  • Thanjavur, Tamil Nadu, India
  • Thyagarajan Subramanian MD
  • Professor of Neurology and Neural and Behavioral
  • Sciences
  • Department of Neurology
  • Penn State College of Medicine
  • Hershey, PA, USA
  • Venkatesan Rajmohan MBBS
  • Consulting Physician
  • Coimbatore, Tamil Nadu, India
  • Vikram Shivkumar MD
  • Assistant Professor
  • Department of Neurology
  • Marshall University School of Medicine
  • Huntington, West Virginia, USA
  • Vinothkanna Selvaraj MD DM
  • Associate Professor
  • Department of Neurology
  • Saveetha Medical College Hospital
  • Chennai, Tamil Nadu, India
FOREWORD
It is a great pleasure to write this foreword for Practice Pearls in Neurology, Series III. This is indeed a real collection of pearls. Neurological manifestations of systemic disorders are common. Renal dysfunctions are commonly associated with acute neurological syndromes and vice-versa. These have been highlighted as well. Neuro ophthalmology with approach to visual loss is written well. Optical coherence tomography (OCT) is gaining importance particularly in neurological practice and has been dealt with in detail. Idiopathic intracranial hypertension is more often dealt with by neurologists than neuro surgeons and the topic has received the attention it deserves. The cranial nerve conditions—Trigeminal Neuralgia and Bell's Palsy have been described with attention devoted to the complex anatomy and physiology of these two nerves. Practical management of these two conditions covering all aspects has been appropriately highlighted. It is beneficial to undergraduates, postgraduates and consultants to read the ‘Approach to Brachial Plexopathies’ which describes the applied anatomy, clinical manifestations, electro physiology and treatment including surgical approach. The dilemmas in anticoagulant therapy in neurology have been controversial. These have been dealt with clearly.
Neurogenic dysphagia and its management have been described comprehensively yet succinctly. Five chapters have been devoted to parkinsonism which is a common neurological disorder. It is refreshing to note the clear discussions in all these chapters which include—Early Parkinson's Disease, Levodopa-induced Dyskinesias, Approach to Falls and Freezing in Parkinson's Disease, Continuous Dopaminergic Stimulation in Parkinson's Disease and Parkinson-plus Syndromes.
The contributing authors have painstakingly scanned through the literature and judiciously combined it with their own experiences, the result of which is this commendable booklet. It is a very useful handbook for students, residents, consultants and experts in neurology.
Special thanks to Dr D Vasudevan, Dr Bhanu Kesavamurthy and Dr AV Srinivasan who have taken all efforts to make this pearl very useful to the Neurological community.
Padma Shri Prof. CU Velmurugendran
MD DM FAMS FRCP DSc (Hon Causa)
Professor Emeritus
Dr MGR Medical University
Chennai, Tamil Nadu, India
PREFACE TO SERIES III
The overwhelmingly positive response to the first two books in the Series of Practice Pearls in Neurology has been the stimulus for the compilation of this final volume. Continuing to abide by the same principles which served us well in the earlier volumes, we have selected a wide range of topics with immense practical value to complete this series. As with the earlier volumes in this series, the expertise and experience of the faculty shines through each chapter. We are profoundly grateful to all the faculty members for their contribution to the successful realization of our goal of completing this series within specified timelines. It is our hope and belief that this final volume will round off this series covering many poorly charted areas in the neurological map and be of abiding use and value to the practitioners and students of neurology. We are grateful to Jaypee Brothers Medical Publishers (P) Ltd for their seamless guidance and help in bringing out these three series. Without the continued and selfless support of our families, this endeavour would not have fructified.
Bhanu Kesavamurthy
D Vasudevan
AV Srinivasan
PREFACE TO SERIES I
Practice Pearls in Neurology has been conceived and executed as a unique compilation of the topics elaborated in the annual seminars which go by the same name. These seminars have been conducted over the past three years and will be continued in the years to come. The abiding principle of these day long seminars have been to present commonly encountered (but seldom dealt with in standard books in a practically useful manner) conditions, in such a way as to help the novice as well as the adept. The presentations are aimed at focusing on knowledge or experience crystallized over the years into valuable pearls of wisdom pertaining to the topics under consideration.
A galaxy of teachers with rich clinical experience are the faculty for these seminars. This compilation of select topics gleaned from the collection forms Series 1 of the Practice Pearls in Neurology Series. The contributing authors have dealt with their respective topics in a succinct and exemplary manner. We are grateful to all the authors for both their excellent contribution and their patience. We are especially delighted that the doyen of neurology, Professor CU Velmurugendran agreed to write the foreword for this book. We are grateful to Mr MB Kumaresh menon and Ms Sheetal Arora at Jaypee Brothers Medical Publishers for their help. We are thankful to our families for their constant support.
AV Srinivasan
D Vasudevan
Bhanu Kesavamurthy