The Case of the Dizzy and Confused:
A 32 year old has had 4 weeks of progressive confusion and vertigo. Exam shows a mild left hemiparesis and end-gaze nystagmus with right upward gaze.
What’s going on here #neurotwitter?
A 52 year old woman comes in for evaluation of daily headaches. They’ve been present for about 2 years, occur on awakening, and resolve after her morning coffee.
Her neurologic exam is completely normal.
What do you do next for this patient?🧵#ContinuumCase
Neurology is so cool:
A 61 year old man comes in for another opinion on his diagnosis of ALS
Several years of progressive upper limb weakness
Exam: upper limb fasciculations, brisk lower limb reflexes
One look at the C-spine MR and you know it’s not ALS. What’s going on?
Neurologic differential for the new academic year:
➡️ Determine timeline: acute, subacute, chronic
➡️ Localization: focal (one place) or diffuse (widespread)
Use this grid, work up what’s in that box. If it’s not there, it’s in an adjacent box
#PostItPearls#NeuroPostItPearls
How to Weakness:
Localization is a barrier in neurology, but fortunately there are only 4 locations that cause most weakness:
1 Upper motor neuron
2 Lower motor neuron
3 Neuromuscular junction
4 Muscle
A 75 year old woman comes to the ED with 3 days of low back pain, imbalance, and tingly feet
She has diabetes and melanoma. “I just finished my first round of chemo last week!”
She has moderate lower limb weakness & absent reflexes
How would you approach this #ContinuumCase?🧵
It’s official! The latest Continuum issue on Cerebrovascular Disease is online, and shipping!
🧠Latest on treatment and prevention of acute ischemic stroke
🧠Diagnosis and management of CV disorders (CVT, dissection, AVMs)
🧠Pediatric stroke
Link: journals.lww.com/continuum/page…
Do neurologists need to know how to manage pain?
We think so, and our first ever issue of Continuum completely dedicated to pain is online and shipping!
Why dedicate a full issue of a neurology journal to pain management? 1/
Issue link: journals.lww.com/continuum/page…
#ContinuumCase!
A 48 year old is found unresponsive by her family. She was intubated for respiratory depression with no response to naloxone. She was comatose with intact brainstem reflexes
Urine drug screen was negative. MRI below (DWI⬆️/FLAIR⬇️)
What’s the diagnosis???🧵
