Neurology Course

Drexel University

Neurology Course

David S. Tabby D.O., Course Director

Introduction
Goals
Objectives
The General Structure of the Course
Evaluation
Textbooks and Learning Resources

Only the course with identification of NEUL8014Sxxx will be accepted for this course. No substitutions may be made.

I. Introduction

Neurologic symptoms are commonly presented to primary care doctors. Common diseases such as stroke, migraine and dementia, are a few examples. Physicians require a good understanding of the general principles of clinical neurology to be able to better serve their patients.

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II. Goals

To teach the principles and skills required to recognize and manage common neurological disorders. These include the ability to obtain a good history and perform a neurologic examination.

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III. Objectives

To teach or reinforce the following procedural skills:
1. The ability to obtain a complete and reliable history, specifically related to neurological complaints.
2. The ability to perform a reliable neurologic examination.
3. The ability to examine patients with altered level of consciousness or abnormal mental status.
4. The ability to deliver a clear, concise, and thorough oral presentation of a patient's history and examination.
5. The ability of prepare a clear, concise, and thorough written presentation of a patient's history and examination.
6. [Ideally] The ability to perform a lumbar puncture.
To teach or reinforce the following analytical skills:
1. The ability to recognize symptoms of neurologic disease.
2. The ability to distinguish normal from abnormal findings on a neurologic examination.
3. The ability to localize signs, symptoms and findings in the neurological examination to the likely site or sites in the nervous system that may be affected.
4. The ability to formulate a differential diagnosis based on lesion localization, time course, and relevant historical and demographic features.
5. The ability to formulate a plan for evaluation and diagnosis. Awareness of the use and interpretation of common tests used in diagnosing neurologic disease.
6. The principles underlying a systematic approach to the management of common neurological diseases. The ability to recognize and manage neruological emergencies.
7. An awareness of situations in which it is appropriate to request neurologic consultation.
8. Review of neuroanatomy and neurophysiology applied to clinical neurology.
9. Comprehensive review of common neurologic diseases.
10. Principles of pharmacotherapy in clinical neurology.
11. Principles of genetics in clinical neurology.
  
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IV. The General Structure of the Course

Students will be taught with formal lectures, attendance to conferences, supervised exposure to patients and participation in the clinical team.
1. The Neurologic Examination (as an integral component of the general medical examination).
  1. How to perform a focused but thorough neurologic examination.
  2. How to perform a neurologic examination on patients with an altered level of consciousness.
  3. How to recognize and interpret abnormal findings on the neurologic examination.
2. Localization - general principles differentiating lesions at the following levels:
  1. Cerebral hemisphere.
  2. Posterior fossa.
  3. Spinal cord.
  4. Nerve root/Plexus.
  5. Peripheral nerve (mononeuropathy, polyneuropathy, and mononeuropathy multiplex).
  6. Neuromuscular junction.
  7. Muscle.
3. Symptom Complexes - a systematic approach to tthe evaluation and differential diagnosis of patients who present with:
  1. Focal weakness.
  2. Diffuse weakness.
  3. Clumsiness.
  4. Involuntary movements.
  5. Gait disturbance.
  6. Urinary or fecal incontinence.
  7. Dizziness.
  8. Vision loss.
  9. Diplopia.
  10. Dysarthria.
  11. Dyphagia.
  12. Acute mental status changes.
  13. Dementia.
  14. Aphasia.
  15. Headache.
  16. Focal pain
    1. Facial pain.
    2. Neck pain.
    3. Low back pain.
    4. Neuropathic pain
  17. Numbness or paresthesias.
  18. Transient or episodic focal symptoms.
  19. Transient or episodic alteration of consciousness.
  20. Sleep disorders.
  21. Developmental disorders.
4. Approach to Specific Diseases - general principles for recognizing, evaluating and managing the following neurologic conditions (either because they are important prototypes, or because they are potentially life-threatening):
  1. Potential emergencies:
    1. Increased intracranial pressure.
    2. Toxic-metabolic encephalopathy.
    3. Subarachnoid hemmorage.
    4. Meningitis/Encephalitis.
    5. Status epilepticus.
    6. Acute stroke (ischemic or hemorrhagic).
    7. Spinal cord or cauda equina compression.
    8. Head Trauma.
    9. Acute respiratory distress due to neuromuscular disease (e.g., myasthenic crisis or acute inflammatory demyelinating ployradiculoneuropathy).
    10. Temporal arteritis.
  2. Strokes.
  3. Seizures.
  4. Alzheimer's disease.
  5. Parkinson's disease.
  6. Essential tremor.
  7. Multiple sclerosis.
  8. Migraine.
  9. Bell's palsy.
  10. Carpal tunnel syndrome.
  11. Diabetic polyneuropathy.
  12. Brain death.
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V. Evaluation

Students will be evaluated at all sites by the neurology faculty and the resident working with the student. The clinical evaluation corresponds to 65% of the final grade.

Passing the shelf exam is a requirement to passing the course. The grade in the written exam will be 35% of the final grade.
If a student fails the exam he/she will have the opportunity to take it again after completing remedial work. If the student fails a second time, the entire course will have to be repeated.

Attendance at all conferences is mandatory. Morning report (including Saturday and/or Sunday at the attending or resident's request) and lectures are all mandatory for all students.

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VI. Textbooks and Learning Resources

Neurology Syllabus.
Principles of Neurology - Adams and Victor.
Merritt's Textbook of Neurology - Lewis Roland.
Memorix Neurology Peter Berlit. Chapman & Hall Medical.
Localization in Clnical Neurology - Brazis, Masdeu, Biller.
Neurology in Clinical Practice - Bradley, Daroff, Fenichel, Masdeu.
http://www.aan.com/
http://www.mcphu.edu/medschool/depts/neurology/home.htm
http://www.strokeassociation.org/
http://www.stroke-site.org/

Only the course with identification of NEUL8014Sxxx will be accepted for this course. No substitutions may be made.
revised 11/12/03
Š1996, MCP Hahnemann University