Clinical Cases Uncovered Neurology PDF
13.4 MB PDF
This book has been written by three neurologists who (we hope!) are nearer the beginning of our careers than the end, and at the time of writing two were still in formal neurological training. Our intention is to give the reader a new perspective to understand better what the phenomenal advances in our understanding of the brain mean in day to day clinical practice. In the past such books existed as the major medium through which factual knowledge was communicated to medical students and clinicians. However, such has been the pace of scientific discovery, that role has for some time been obsolete. More recently, textbooks found a role in providing research syntheses, bringing together primary evidence to give recommendations for diagnosis and management. However, with the growth of systematic tools to provide unbiased and timely research synthesis (such as used by the Cochrane Collaboration), that role too is now obsolete.
But reports of the death of the textbook have been exaggerated. At its best, clinical medicine brings the fruits of scientific research to the bedside. That requires not just a knowledge of scientific facts, but an understanding of how these inform disease processes, therapeutics, and how they can help you better understand the patient in front of you. Neurological conditions such as headache, stroke, epilepsy and dementia contribute to considerable morbidity, accounting for a large proportion of presentations to doctors in both primary and secondary care. Medical students find neurological assessment of patients notoriously daunting and this ‘ neurophobia ’ persists throughout postgraduate training. Our purpose here is to show how a patient ’ s journey can be informed by both scientific and clinical knowledge. In doing so, we use illustrative cases which, taken together, provide broad coverage of neurological conditions commonly encountered in clinical practice.
The book is organized in three parts. Part 1 deals with the basic scientific principles underlying neurological disease, and with the fundamentals of neurology history -taking and examination. Part 2 provides 27 clinical cases covering a range of neurological conditions. The sequence of these cases has been determined by formal randomisation, and so the reader may either start at the beginning or dip in and out. Some students may wish to use a particular chapter to ‘ walk them through ’ the presentation of a patient seen in clinic or on the wards. Each case is presented in sequence, with initial presentation, followed by a discussion of the key features to elicit on history and then on examination; discussion of the implications of evidence collected; appropriate investigations and the implications of findings; and management options. Each case ends with a case review and listing of key points and references. Part 3 provides plentiful self – assessment material including multiple choice questions, extended choice questions and self – assessment questions.
The book is designed for medical students with clinical attachments in neurology and in the run up to examinations. However, it will also be useful to junior doctors who are faced with patients with neurological conditions and to those undertaking further training in internal medicine, geriatric medicine or neurology. We hope that you find this book both useful and interesting, and we hope it conveys some idea of how stimulating and rewarding neurology can be.
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