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Neurology
  1. Neurological Emergencies

  2. Neurological Diseases & Disorders A-Z

Neurological Emergencies
When to Go to the ER with Neurological Symptoms
  1. Alteration in Consciousness

  2. Fever and Confusion

  3. Weakness and Difficulty Breathing

  4. Face drooping

  5. Weakness

  6. Speech difficulty

  7. Numbness or paralysis

  8. Severe headache

  9. Vision problems

  10. Confusion

  11. Difficulty walking or feeling unsteady

  12. Severe pain that begins suddenly

  13. Blurred, double vision or loss of vision

  14. Slurred speech

  15. Sudden, severe headache or prolonged migraine headache Weakness in upper or lower extremities

  16. Dizziness

  17. Vomiting

  18. Confusion or altered mental status

  19. Drooping in the face Head injury/trauma

  20. Numbness/tingling of the face, arm or leg on one side of the body

  21. Seizures without a previous diagnosis of epilepsy

  22. Other Call your doctor if you have any of these neurological symptoms:

  23. Severe headaches or migraines

  24. Chronic lower back or neck pain

  25. Seizures or tremors

  26. Loss of consciousness

  27. Confusion or disorientation

  28. Sudden dizziness or loss of balance

  29. Memory loss

  30. Concussion

  31. Coordination or movement problems

  32. Chronic insomnia

  33. Muscle stiffness, rigid limbs or muscle spasms

  34. Muscle weakness or numbness

  35. Nausea and/or vomiting

  36. Tingling sensations

  37. Decrease in sensations

  38. Loss of bowel and/or bladder control

  39. Blurry or double-vision

Alteration in Consciousness
Causes / Differential diagnosis
Trauma
Illnesses / Metabolic / See coma causes
Medications?drugs, alcohol.
Psychiatric disorders.

Fever and Confusion
Causes / Differential diagnosis
Meningitis (bacterial, viral)
Encephalitis (viral)
Cerebral abscess (bacterial, toxoplasma, fungal)
Subdural empyema
Endocarditis with septic embolic brain infarcts
Non-CNS infection with secondary encephalopathy

Weakness and Difficulty Breathing
Causes / Differential diagnosis
Differential diagnosis
Guillain-Barre syndrome
Myasthenic crisis
Cervical cord lesion
Severe myopathy
Sepsis

Diagnosis
Emergency

Neurological diagnoses in the emergency
  1. Status Epilepticus

  2. Stroke

  3. Vegetative state

  4. Brainstem failure

  5. Coma

  6. Infections / Meningitis?Viral?Bacterial?Fungus / Encephalitis Viral

  7. Bacterial Usually abscess

  8. Myasthenic crisis

  9. Guillain Bare Syndrome

  10. Spinal cord compression/myelopahy

  11. Acute hypertension and ICH

  12. Sudden, Severe Headache

  13. Intracranial hemorrhage
      Subtypes are intracerebral bleeds (intraventricular bleeds and intraparenchymal bleeds), subarachnoid bleeds, epidural bleeds, and subdural bleeds.
Status Epilepticus

Treatment

Start Lorazepam1-4 mg iv.

Prepare and start Fosphenytoin(Cerebrix) 20 mg PE/Kg IV at a rate of up to 50mg PE/min.

If seizures not stopped then give IV 10 more milligrams PE/Kg

If seizures not stopped then Keppra 1g IV.

If seizures not stopped then Phenobarbital IV 20 mg/Kg (attention to the BP)

If seizures not stopped then intubate and start barbituriccoma under EEG monitoring.

After the seizures stopped do further diagnosis tests to clarify the etiology of the event.?If possible treat the etiology of the status epilepticus.

Stroke

Ischemic about 90%

Anterior circulation about 80%
Posterior circulation about 20%

Hemorrhagic about 10%
AHC IS LIKE HAVING 7 DISEASES AT ONCE:

1. Paralysis like Stroke
2. Seizures and spells of reduced consciousness like Epilepsy (true epilepsy in >50% of cases)
(high risk of SUDEP or rapid severe permanent deterioration)
3. Low muscle tone like Cerebral Palsy (and complications like the inability to breathe and swallow properly)
4. Movement problems like Parkinsonís
5. Behavioral issues like ADHD
6. Learning challenges like Autism
7. Neurodegeneration like Alzheimerís

Neurological Diseases & Disorders A-Z

Human nervous system disorders
How are human nervous system disorders classified?
Vascular disorders
Stroke
Transient ischemic attack (TIA)
Subarachnoid hemorrhage
Subdural hemorrhage and hematoma
Extradural hemorrhage
Infections
Meningitis
Encephalitis
Polio
Epidural abscess
Structural disorders
Brain (Head Injury)
Spinal cord injury (Acute Spinal Cord Injury)
Bell's palsy
Cervical spondylosis, carpal tunnel syndrome
Brain or spinal cord tumors
Peripheral neuropathy
Guillain-Barre syndrome
Functional disorders
Headache
Epilepsy
Dizziness
Neuralgia
Degeneration
Parkinson's disease
Multiple sclerosis
Amyotrophic lateral sclerosis (ALS)
Huntington's chorea
Alzheimer's disease
Metabolic encephalopathy
Hepatic encephalopathy
Hypoxic ischemic encephalopathy
Uremic encephalopathy
Toxic encephalopathy
Toxic-Metabolic encephalopathy
Hypertensive encephalopathy
Wernicke's encephalopathy
Glycine encephalopathy
Neonatal encephalopathy
Encephalomyopathy
Hypoglycemia
Hyperosmolar hyperglycemic crisis
Metabolic acidosis
Hyponatremia (hypotonic)
Hypernatremia
Hypercalcemia
Sepsis
Hashimoto's thyroiditis
Acute adrenocortical insufficiency
Hypothermia
Hyperthermia
Coma
Coma
Neurology Research
Last Updated: October 20, 2020