|
Try and think about neurological problems from an anatomical
point-of-view. Split the nervous system up into parts and
ask yourself, “Could the patient’s symptoms be
produced by this part of the nervous system”? You will
usually find that this approach can easily eliminate a long
differential list. Keep in mind that there are exceptions
to every rule in neurology.
| ANATOMY |
FUNCTION |
| Brain |
Often unilateral
Motor and/or sensory
Language
Vision
Memory
Behavior
Consciousness
Seizures |
| Brain stem |
Often unilateral
Motor and/or sensory
Cranial nerves: diplopia, vertigo, hearing, swallow, etc.
Cerebellar
Consciousness |
| Spinal cord |
Bilateral symptoms common
Motor and sensory, usually both
Head OK
Bowel, bladder and erectile |
| Motor neuron |
Asymmetric bilateral
Motor only
Proximal and distal muscles
Slowly progressive
Fasciculations |
| Peripheral nerve |
Symmetric or focal
Sensory > motor
Often distal in stocking/glove distribution |
| Neuromuscular junction |
Asymmetric bilateral
Motor only
Proximal and distal muscles
Fatigable weakness and eye involvement in MG |
| Muscle |
Symmetric bilateral
Motor only
Usually proximal |
|
