Cover -- Half-title -- Title -- Copyright -- Dedication -- Contents -- Foreword -- Preface -- Acknowledgments -- Chapter 1 Confusion -- History -- Agitated delirium -- Somnolence -- Incoherence -- Examination -- Inattention -- Months of the year backwards -- Reverse digit span -- Serial sevens -- Spelling "world" backwards -- Other changes in mental status -- Asterixis -- Differential diagnosis -- Aphasia -- Neglect and the right hemispheric syndrome -- Visual neglect -- Somatosensory neglect -- Other elements of the right hemispheric syndrome -- Transient global amnesia -- Psychosis -- Diagnostic testing -- Etiologies -- Toxic and metabolic encephalopathies -- Ethanol and confusion -- Ethanol intoxication -- Ethanol withdrawal -- Wernicke's encephalopathy -- Hepatic encephalopathy -- Spinal fluid pleocytosis -- Bacterial meningitis -- Viral meningitis and encephalitis -- Neoplastic meningitis -- Lyme meningitis -- Tuberculous meningitis -- Fungal meningitis -- Drug-induced meningitis -- Limbic encephalitis -- Nonconvulsive status epilepticus -- Structural lesions responsible for confusion -- Posterior reversible encephalopathy syndrome -- General approach to treatment -- References -- Chapter 2 Coma -- History -- Examination -- Mental status examination -- Pupillary reactions -- Blink reflexes -- Eye position -- Horizontal eye position -- Vertical eye position -- Spontaneous eye movements -- Oculocephalic responses -- Motor examination -- Spontaneous and purposeful -- Spontaneous but nonpurposeful -- Reflexive -- Absent -- Respiratory patterns -- Investigation of impaired consciousness and coma -- Phase 1: history, examination, and basic studies -- Phase 2: MRI, electroencephalography, and lumbar puncture -- Phase 3: uncommon etiologies and coma mimics -- Prognostication in coma -- The persistent vegetative state -- Brain death.

Increased intracranial pressure -- Uncal herniation -- Transtentorial herniation -- Management of increased intracranial pressure -- References -- Chapter 3 Aphasia -- Introduction -- Mimics of aphasia -- Bedside examination of the aphasic patient -- Spontaneous speech -- Comprehension -- Repetition -- Confrontation naming -- Reading -- Writing -- Aphasia syndromes -- Broca's aphasia -- Wernicke's aphasia -- Global aphasia -- Transcortical motor aphasia -- Conduction aphasia -- Transcortical sensory aphasia and mixed transcortical aphasia -- Subcortical aphasias -- Anomic aphasia -- Aphemia -- Determining the cause and treatment of aphasia -- Recovery and rehabilitation of acute aphasia -- References -- Chapter 4 Dementia -- History -- Memory -- Language -- Praxis -- Visuospatial function -- Behavioral abnormalities -- Gait difficulties -- Relevant medical history -- Age of onset, tempo, and fluctuations -- Examination -- Mental status examination -- Attention -- Language -- Semantic fluency -- Phonemic fluency -- Memory -- Praxis -- Construction -- Mental flexibility -- Luria test -- Stroop test -- Processing speed -- Frontal release signs -- The general neurological examination -- Cranial nerve examination -- Motor examination -- Sensory examination -- Gait -- Diagnostic testing -- Bloodwork -- Structural neuroimaging -- Functional neuroimaging -- Lumbar puncture -- Genetic testing -- Causes of dementia -- Alzheimer's disease -- Dementia with Lewy bodies -- Frontotemporal dementia -- Vascular dementia -- Multi-infarct dementia -- Subcortical white matter disease -- Strategic infarct dementia -- Normal pressure hydrocephalus -- Primary progressive aphasia -- Alcohol and dementia -- Human immunodeficiency virus dementia -- Neurosyphilis -- Dementia and movement disorders -- Mild cognitive impairment -- Pseudodementia -- Depression.

Obstructive sleep apnea and other sleep disorders -- Pain -- Adult attention deficit hyperactivity disorder -- Conversion disorders and malingering -- Postconcussion syndrome -- Subacute and rapidly progressive dementias -- Creutzfeldt-Jacob disease -- Hashimoto's encephalopathy -- Leptomeningeal metastasis and limbic encephalitis -- References -- Chapter 5 Visual loss -- Neuroanatomy -- History -- Examination of the visual system -- Visual acuity -- Pupillary reactions -- Relative afferent pupillary defect -- Color discrimination -- Visual field examination -- Central visual fields -- Peripheral visual fields -- Common patterns of visual field deficits -- Funduscopic examination -- Monocular visual loss -- Optic neuritis -- Idiopathic optic neuritis -- Atypical optic neuritis -- Ischemic optic neuropathies -- Temporal arteritis -- Nonarteritic ischemic optic neuropathy -- Less common optic neuropathies -- Structural optic neuropathies -- Toxic and nutritional optic neuropathies -- Inherited optic neuropathies -- Retinal ischemia and infarction -- Migraine aura without headache -- Angle-closure glaucoma -- Bitemporal hemianopsia and junctional scotoma -- Homonymous upper quadrantanopsia -- Homonymous hemianopsia -- Posterior cerebral artery infarction -- Alexia without agraphia -- Cortical blindness -- Bilateral occipital lobe infarction -- Posterior reversible encephalopathy syndrome -- Functional visual loss -- References -- Chapter 6 Diplopia -- Establishing binocularity and direction of diplopia -- Inspecting ocular misalignment -- Localizing the dysfunctional eye movement -- Localizations of horizontal diplopia -- Abducens nerve palsy -- Nuclear lesions -- Fascicular lesions -- Prepontine segment lesions -- Cavernous sinus and orbit lesions -- Partial oculomotor (cranial nerve III) palsy -- Internuclear ophthalmoplegia.

Localizations of vertical diplopia -- Trochlear nerve palsy -- Nuclear, fascicular, and cisternal segment lesions -- Cavernous sinus and orbit lesions -- Skew deviation -- Partial third-nerve palsy -- Localizations that produce diplopia in more than one direction -- Oculomotor nerve palsy -- Nuclear lesions -- Fascicular lesions -- Cisternal segment lesions -- Cavernous sinus lesions -- Pupil-sparing third-nerve lesions -- Wernicke's encephalopathy -- Cavernous sinus lesions -- Tolosa-Hunt syndrome -- Orbital lesions -- Miller Fisher syndrome and brainstem encephalitis -- Cranial polyneuropathy -- Restrictive disorders -- Fluctuating diplopia - ocular myasthenia gravis -- Diagnostic testing -- Treatment -- References -- Chapter 7 Disorders of the eyelids and pupils -- Ptosis and lid retraction -- Supranuclear lesions -- Nuclear and nerve lesions -- Oculomotor nuclear and nerve lesions -- Oculosympathetic nerves -- Facial nerve -- Neuromuscular junction lesions -- Muscle lesions -- Soft tissue lesions -- Lid retraction -- Treatment of ptosis and lid retraction -- Other disorders of the eyelids -- Blepharospasm -- Eyelid-opening apraxia -- Anisocoria -- Anisocoria worse in light (parasympathetic dysfunction) -- Nuclear lesions -- Fascicular and subarachnoid lesions -- Cavernous sinus lesions -- Ciliary ganglion lesions -- Iris lesions -- Clinical approach -- Anisocoria worse in the dark (sympathetic dysfunction) -- First-order neuron -- Second-order neuron -- Third-order neuron -- Clinical approach -- Physiological anisocoria -- References -- Chapter 8 Facial weakness, dysarthria, and dysphagia -- Lower brainstem (bulbar) symptoms -- Facial weakness -- Anatomy -- Examination of the functions of the facial nerve -- Differentiating between central and peripheral facial weakness -- Causes of facial weakness -- Supranuclear lesions -- Pontine lesions.

Bell's palsy and other lesions of the facial nerve proper -- Incidental facial weakness -- Dysarthria -- Spastic (upper motor neuron) dysarthria -- Flaccid (lower motor neuron) dysarthria -- Extrapyramidal dysarthrias -- Scanning (cerebellar) dysarthria -- "Slurred" speech -- Dysphagia -- Oral phase dysphagia -- Trigeminal nerve lesions -- Hypoglossal nerve lesions -- Pharyngeal phase dysphagia -- Supranuclear lesions (the pseudobulbar state) -- Nuclear lesions -- Glossopharyngeal and vagus nerve lesions -- Neuromuscular junction lesions -- Myopathic lesions -- Extrapyramidal lesions -- References -- Chapter 9 Dizziness and vertigo -- "What do you mean by dizziness?" -- Lightheadedness -- Cardiogenic syncope -- Orthostatic hypotension -- Neurally mediated syncope -- Postural tachycardia syndrome -- Dizziness of psychological origin -- Imbalance -- Evaluation of vertigo -- History -- Neurological examination -- "Cerebellar" signs -- Finger-to-nose test -- Overshoot -- Rebound -- Heel-knee-shin test -- Truncal ataxia -- Nystagmus -- Head-thrust test -- Dix-Hallpike maneuver -- Imaging of the patient with vertigo -- Causes of vertigo -- Vertebrobasilar ischemia and infarction -- Vestibular neuritis -- Benign paroxysmal positional vertigo -- Ménière's disease -- Migraine -- Medication toxicity -- Perilymph fistula -- Epileptic dizziness -- Cerebellopontine angle tumors -- Chronic undifferentiated dizziness -- Postconcussion syndrome and posttraumatic dizziness -- Multiple sclerosis -- Paraneoplastic cerebellar degeneration -- Episodic ataxia -- References -- Chapter 10 Proximal and generalized weakness -- Weakness and its mimics -- The evaluation of weakness -- Proximal weakness -- History -- Associated features -- Examination -- Muscle bulk -- Muscle strength -- Exercise testing -- Reflexes -- Sensation -- Gait -- Other signs and symptoms.

Laboratory testing in the patient with proximal weakness.