By Klaus Poeck
Throughout the process background it has continuously been famous that any rules approximately mind functionality depended upon the top technological version of the day. accordingly, within the Greek or Roman period the ventricular method used to be singled out as a result of the devel opment of hydraulics. Early during this century we drew the analo gy among mobilephone circuits and the mind. Now it truly is renowned to symbolize neural functionality as that of a worldly com puter. certainly, in lots of methods it can be. yet, as but, the pre pared human mind will most probably be triumphant within the checking out of data beneficial for a formal analysis. during this guide, POECK has supplied the floor paintings for such prepara Dr. tion. all of us recognize the shrewdpermanent diagnostician, and typically ascribe the ability to nice instinct. no longer so! it's the clinician who has visible many sufferers, and has compiled a menu of decisions. Dr. POECK is any such clinician, and he has supplied us along with his menu of selections. Use of those lists will most likely reduction the coed or resident health professional in coming to a formal analysis yet, extra importantly, may help teach his or her brain to imagine in a logical and systematic means. ROBERT J. JOYNT, M.D., Ph.D.
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Extra info for Diagnostic Decisions in Neurology
Quite frequently, the involuntary movements of the tongue and the incoordination of oral, pharyngeal, and laryngeal muscles make chewing and swallowing impossible. This should prevent a misdiagnosis of psychogenic hyperkinesia. 4 Hypersensitivity to Dopaminergic Drugs The choreic movements after long-term levodopa therapy or therapy with dopamine agonists in patients with Parkinson's disease are too well known to require detailed discussion here. The movements particularly affect the muscles of the shoulder girdle and the muscles which move the head, earlier than they affect the distal hand and foot muscles.
5 Severe Traumatic Brain Damage A patient with severe traumatic brain damage may have gross psychopathological and neuropsychological alterations. If one hemisphere is affected there will be neuropsychological impairment such as aphasia, spatial disorientation, and disturbance of attention, of memory, and of the ability to adapt to rapidly changing demands, to name but a few. After brain stem damage there are predominantly emotional changes, and a loss of spontaneity. The diagnosis poses no problems if the trauma is known or detected by neuroimaging.
A history of instances of brain stem dysfunction gives an important clue. More often than not, ultrasound examination is unremarkable, as is angiography of the hindbrain circulation, because the small brain stem vessels are not visualized. Brain stem hemorrhage is diagnosed by neuroimaging. 10 Metastatic Brain Stem Lesions The most frequent location of metastatic brain stem lesions is the midbrain level, where they lead to third nerve palsy or paralysis of upward gaze. They may be visualized by neuroimaging with contrast or by angiography.
Diagnostic Decisions in Neurology by Klaus Poeck