NEUROLOGY - MOVEMENT + DEMYELINATION + NEUROMUSCULAR
YEAR 3 | PAGE 32C - CHRONIC PATTERNS + PERIPHERAL LOCALIZATION + NEURO
E. CHRONIC NEUROLOGY - PATTERN BEFORE TEST
| Domain | Pattern recognition | Key diagnostic / management logic |
|---|---|---|
| Parkinsonism / tremor | Bradykinesia + rigidity/rest tremor/postural-gait change; distinguish essential tremor, drug-induced parkinsonism, atypical features. | The exam pattern matters more than a single tremor description; review medication adverse effects and fall/cognition/autonomic burden. |
| Demyelination | CNS lesions separated in time/space; optic neuritis, INO, sensory/motor/cerebellar syndromes. | Differentiate CNS demyelination from peripheral demyelination; MRI/CSF and syndrome context guide diagnosis. |
| Peripheral neuropathy / radiculopathy | Length-dependent stocking-glove vs named nerve vs dermatomal pain/weakness/reflex change. | Use anatomy and reflexes to decide whether electrodiagnostics, spine imaging or metabolic/toxic workup is useful. |
| Myasthenia / LEMS | MG: fatigable ocular/bulbar/proximal weakness, sensation intact. LEMS: proximal weakness + autonomic clues, often improves with activity. | Respiratory/bulbar weakness changes urgency; medication triggers and associated disease matter. |
| GBS / myopathy | GBS: progressive weakness + areflexia, often sensory/autonomic symptoms. Myopathy: proximal weakness, sensation preserved, CK/myopathic clues. | Serial respiratory/autonomic assessment can be more urgent than confirming the subtype. |
| Cognitive / degenerative | Tempo + cognitive domain + motor/behavioral/autonomic clues; separate delirium from dementia. | Acute inattention/fluctuation is delirium until proven otherwise; chronic syndromes require function + reversible-cause context. |
F. NEUROLOGIC EMERGENCY TRIGGERS
| Trigger | Immediate concern | Do not miss |
|---|---|---|
| Declining consciousness + anisocoria / posturing | Raised ICP / herniation / mass effect. | Urgent stabilization + imaging/neurosurgical pathway; do not perform a nonessential procedure that delays treatment. |
| Fever + altered mental status / meningismus / seizure | Meningitis or encephalitis. | Time-sensitive empiric therapy and appropriate imaging/LP sequence depend on stability and herniation risk. |
| Back pain + weakness + sensory level or bladder/bowel symptoms | Cord compression, cauda equina, epidural process. | Urgent spinal imaging and definitive specialty management. |
| Rapid ascending weakness / bulbar symptoms | GBS or NMJ crisis with respiratory failure risk. | Serial respiratory mechanics, airway planning and autonomic monitoring. |
| Acute painful vision loss / monocular loss / diplopia with focal | Optic neuritis, retinal/vascular emergency, cranial neuropathy or brainstem disease. | Localize eye vs optic nerve vs pathway; vision-threatening causes need urgent specialty evaluation. |
| findings Ninja Nerd - Multiple Sclerosis (~54 min) Stanford Medicine 25 - Parkinson Disease Physical Exam Ninja Nerd - Neuromuscular Junction Pathologies (MG / LEMS) 2026/27 clerkship-expanded edition - verify school and official exam updates before testing |