Emergency Neurology: A Comprehensive Guide for Clinicians

By Thomas P. Campbell

Emergency departments frequently encounter patients with neurologic symptoms, requiring prompt and thorough evaluation to prevent patient morbidity. This guide provides a succinct overview of the essential steps in assessing and managing these patients, including tailored history-taking, localization of the neurological problem, differential diagnosis, focused testing, and urgent treatment when indicated.

Neurological Examination and Testing

This section delves into the in-depth assessment of patients’ neurological status, including the performance and interpretation of various neurological tests. It emphasizes the importance of a thorough neurological examination in guiding further diagnostic workup and treatment.

Common Neurological Presentations

This symptom-based approach explores common neurological presentations seen in the emergency department, such as:

• Coma: The evaluation and management of comatose patients, including the Glasgow Coma Scale and key diagnostic considerations.
• Dizziness and Gait Disturbance: Approaches to assessing and managing patients with dizziness and gait disturbances, including the importance of thorough history-taking and targeted physical examination.

Specific Neurological Disorders

This section covers the evaluation and management of specific neurological disorders frequently encountered in the emergency department, including:

• Traumatic Brain Injury: The assessment and treatment of patients with traumatic brain injuries, highlighting the importance of prompt recognition and intervention.
• Ischemic Stroke and Transient Ischemic Attack: The evaluation and management of patients with suspected ischemic stroke or transient ischemic attack, emphasizing the critical role of timely diagnosis and treatment.
• Neurotoxicology: The recognition and management of neurotoxic exposures, including key substances and their effects on the nervous system.

Chapters Outline

Each chapter follows a structured outline, providing a clear and concise overview of the topic. Key sections include:

• Introduction: A brief overview of the chapter’s focus and importance in emergency neurology.
• Pearls and Pitfalls: Key takeaway points for the busy clinician, highlighting critical information and common pitfalls to avoid.

Conclusion

This handbook serves as a valuable reference for clinicians encountering neurological emergencies. By providing a comprehensive yet concise guide, it aims to enhance the evaluation and management of patients with neurological symptoms in the emergency department.