SEABEE OPERATIONAL MEDICAL & DENTAL GUIDE NEUROLOGY

SEABEE OPERATIONAL MEDICAL & DENTAL GUIDE NEUROLOGY Return to Clinical Section Welcome Page C O N T E N T S I INTRODUCTION II NEW ONSET SEIZURES III VERTIGO AND DISEQUILIBRIUM IV SEIZURES AND OTHER SPELLS V MANAGEMENT OF COMA AND UNRESPONSIVENESS VI CENTRAL NERVOUS SYSTEM INFECTIONS VII HEADACHES VIII MANAGEMENT OF ACUTE SPINAL CORD INJURIES I. INTRODUCTION This section is written for physicians who treat patients with neurological complaints. It covers both common neurological complaints and life threatening neurological

disorders, and provides basic guidelines for adequate diagnosis and treatment of these conditions. As neurological consultation and expensive neurodiagnostic testing are often unavailable, reliance on history and examination will be emphasized. General Neurological Evaluation The primary goals in neurological evaluation are lesion placement and differential diagnosis determination. Place the lesion in one of the following five areas: • The cerebral hemispheres (i.e., supratentorial) • The brain stem or cerebellum (i.e., infratentorial) • The spinal cord level • Peripheral nerve and/or nerve root Muscle Be aware that isolated musculoskeletal problems may present as neurological complaints. A convenient mnemonic for remembering the neurological differential diagnosis is VIN DIITTCH MD: V Vascular I Infectious N Neoplastic D Demyelinating I Idiopathic I Immune T Trauma NEUROLOGY SEABEE OPERATIONAL MEDICAL & DENTAL GUIDE T Toxic C Congenital H Hereditary M Metabolic D Degenerative Obtain a thorough history, with specific emphasis on the chief complaint. If possible, establish the time course, including onset, progression, duration, recurrence, and resolution. The time course is often a clue to the most likely etiology. For example, a chronic, slowly progressive condition may indicate a neoplastic or degenerative process, whereas an intermittent deficit may suggest a vascular or demyelinating condition. With...

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