Neurology

CH 1. OUTPATIENT NEUROLOGY Introduction CH 2. PRESENTING PROBLEMS Memory, language and dementia Vision Isolated cranial neuropathies Fits, faints and other attacks Stokes and transient ischaemic attacks Dizziness and deafness Headaches Speech and swallowing Weakness Numbness and tingling Difficulty in walking Spinal and limb pain Involuntary movements Cramps and stiffness Hereditary disorders Parkinsonism Sleepiness Fatigue Symptoms following head injuries Non organic symptoms and signs Anxiety and depression CH 3. INVESTIGATIONS: A PRACTICAL APPROACH CT scanning MRI scanning EEG EMG and nerve conduction studies Evoked potentials Telemetry and other specialised EEG methods Blood tests (including anticonvulsant levels) Inpatient or outpatients tests? Lumbar puncture Angiography Myelography When to request tests and when not to How to request tests Waiting lists for tests Obtaining results and what to do about them CH 4. RUNNING A CLINIC Referral letters and telephone calls Waiting lists and allocation of appointments Timing and duration of appointments General points about consultations Taking a history and examining patients Diagnoses, explanations and plans Writing to GPs Telephone enquiries Follow up appointments Admissions and waiting lists Discharging patients CH 5. SPECIAL ISSUES Subspecialty clinics Clinics in remote hospitals (hub and spoke system) Teaching outpatients Urgent situations in outpatient practice: when to act quickly Handling difficult consultations Referral to other specialists Somatisation and abnormal illness behavior Driving, employment and benefits Dealing with complaints Medicolegal aspects of outpatient neurology CH 6. WORKING IN TEAMS Outpatient nurses Nurse specialists Occupational therapists Physiotherapists THE GENERAL PRACTITIONER'S PERSPECTIVE