Core Adult Internal Medicine Disciplines

Nuerology

Topics

• Ability to take a competent neurological history and perform a full neurological examination.
  
• Clinical evaluation of the common presenting neurological symptoms such as headache, blackouts, coma, dizziness, confusion, poor memory, weakness, involuntary movements, pins and needles and pain.
  
• Ability to diagnose common neurological disorders including stroke and transient ischaemic attack, subarachnoid haemorrhage, epilepsy; nonepileptic seizures and other psychogenic illnesses; migraine, dementia, multiple sclerosis, Parkinson's disease, myelopathy, motor neurone disease, radiculopathy, peripheral neuropathy, peripheral nerve lesions, meningitis and encephalitis, myopathies and Bell's palsy.
  
• Recognition and early treatment with appropriate onward referral of neurological emergencies such as coma, raised intracranial pressure, status epilepticus, infection, visual failure, spinal cord compression, neuromuscular respiratory failure, including Guillain-Barre syndrome, neoplastic disease, Wernicke-Korsakoff encephalopathy and giant cell arteritis.
  
• Some knowledge of nutritional and metabolic diseases of the nervous system and the neuropsychiatric manifestations of disease.
• Some understanding of the assessment of brain death and an appreciation of the ethical issues associated with managing brain death, terminal motor neurone disease and the entry of patients with coma, aphasia or confusion into research studies.
• Knowledge of the indications, capabilities and limitations of investigations such as CT and MRI of the brain and spinal cord, duplex ultrasonography, spinal CT angiography, MR angiography, EEG, electromyography and nerve conduction studies, evoked potential studies, myelography and invasive digital subtraction cerebral angiography.
• Some knowledge of the indications for neurosurgery.

Practical Skills for all Trainees

• Lumbar puncture.

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