Drugs

192 CRANIAL NERVE DISORDERS

192 CRANIAL NERVE DISORDERS Harrison’s Manual of Medicine 192 CRANIAL NERVE DISORDERS Olfactory Nerve (I) Trigeminal Nerve (V) Facial Nerve (VII) Glossopharyngeal Nerve (IX) Vagus Nerve (X) Hypoglossal Nerve (XII) Multiple Cranial Nerve Palsies Bibliography Disorders of vision and ocular movement are discussed in Chap. 10 and Chap. 48; dizziness and vertigo in Chap. 9; […]

191 ALS AND OTHER MOTOR NEURON DISEASE

191 ALS AND OTHER MOTOR NEURON DISEASES Harrison’s Manual of Medicine 191 ALS AND OTHER MOTOR NEURON DISEASES Etiology Clinical History Physical Examination Laboratory Findings Complications Bibliography Etiology Amyotrophic lateral sclerosis (ALS) is the most important of the motor neuron diseases (Table 191-1). ALS is caused by degeneration of motor neurons at all levels of […]

190 ATAXIC DISORDERS

190 ATAXIC DISORDERS Harrison’s Manual of Medicine 190 ATAXIC DISORDERS Clinical Presentation Inherited Ataxias Evaluation Bibliography Clinical Presentation Symptoms and signs of ataxia may include gait instability, nystagmus, dysarthria (scanning speech), impaired limb coordination, intention tremor (i.e., with movement), hypotonia. Differential diagnosis: Unsteady gait associated with vertigo can resemble gait instability of cerebellar disease but […]

189 PARKINSON’S DISEASE

189 PARKINSON’S DISEASE Harrison’s Manual of Medicine 189 PARKINSON’S DISEASE Clinical Features Etiology Differential Diagnosis Bibliography Clinical Features Parkinsonism consists of tremor, rigidity, bradykinesia, and characteristic abnormalities of gait and posture; may occur with many disorders. Parkinson’s disease (PD) is idiopathic parkinsonism without evidence of more widespread neurologic involvement. Onset between 40 and 70 years […]

188 ALZHEIMER’S DISEASE AND OTHER DEMENTIAS

188 ALZHEIMER’S DISEASE AND OTHER DEMENTIAS Harrison’s Manual of Medicine 188 ALZHEIMER’S DISEASE AND OTHER DEMENTIAS Dementia Alzheimer’s Disease (AD) Other Causes of Dementia Bibliography DEMENTIA Dementia is a deterioration in cognitive ability. Memory loss is most common, but other mental faculties affected may include attention, judgment, comprehension, orientation, learning, calculation, problem solving, mood, and […]

187 MULTIPLE SCLEROSIS (MS)

187 MULTIPLE SCLEROSIS (MS) Harrison’s Manual of Medicine 187 MULTIPLE SCLEROSIS (MS) Clinical Manifestations Physical Examination Disease Course Laboratory Findings Bibliography Characterized by chronic inflammation and selective destruction of CNS myelin; peripheral nervous system is spared. Pathologically, the multifocal scarred lesions of MS are termed plaques. Etiology is thought to be autoimmune, with susceptibility determined […]

186 CHRONIC MENINGITIS

186 CHRONIC MENINGITIS Harrison’s Manual of Medicine 186 CHRONIC MENINGITIS Bibliography Chronic inflammation of the meninges (pia, arachnoid, and dura) can produce profound neurologic disability and may be fatal if not successfully treated. The causes are varied. Five categories of disease account for most cases of chronic meningitis: (1) meningeal infections, (2) malignancy, (3) noninfectious […]

185 ASEPTIC MENINGITIS, VIRAL ENCEPHALITIS, AND PRION DISEASES

185 ASEPTIC MENINGITIS, VIRAL ENCEPHALITIS, AND PRION DISEASES Harrison’s Manual of Medicine 185 ASEPTIC MENINGITIS, VIRAL ENCEPHALITIS, AND PRION DISEASES Viral Meningitis Viral Encephalitis Herpes Zoster (Shingles) Neurologic Complications of HIV Infection Progressive Multifocal Leukoencephalopathy (PML) Prion Diseases Bibliography VIRAL MENINGITIS The syndrome of viral meningitis consists of fever, headache, and meningeal irritation associated with […]

184 BACTERIAL INFECTIONS OF THE CENTRAL NERVOUS SYSTEM

184 BACTERIAL INFECTIONS OF THE CENTRAL NERVOUS SYSTEM Harrison’s Manual of Medicine 184 BACTERIAL INFECTIONS OF THE CENTRAL NERVOUS SYSTEM Acute Bacterial Meningitis Brain Abscess Subdural Empyema Bibliography ACUTE BACTERIAL MENINGITIS The pathogens most frequently involved in bacterial meningitis in immunocompetent adults are Streptococcus pneumoniae (“pneumococcus”) and Neisseria meningitidis (“meningococcus”). Predisposing factors for pneumococcal meningitis […]

183 TUMORS OF THE NERVOUS SYSTEM

183 TUMORS OF THE NERVOUS SYSTEM Harrison’s Manual of Medicine 183 TUMORS OF THE NERVOUS SYSTEM Laboratory Evaluation Intracranial Tumors Complications of Radiation Therapy Bibliography Brain tumors present with: (1) progressive focal neurologic deficits, (2) seizures, or (3) “nonfocal” neurologic disorders (headache, dementia, personality change, gait disorder). Systemic symptoms (malaise, anorexia, weight loss, fever) suggest […]