Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-02T07:09:52.832Z Has data issue: false hasContentIssue false

Section 2 - Common Neurologic Presentations: A Symptom-Based Approach

Published online by Cambridge University Press:  10 January 2024

Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
Get access
Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bibliography

ACEP, AGS, ENA, SAEM, Geriatric Emergency Department Guidelines Task Force. Geriatric emergency department guidelines. Ann Emerg Med 2014;63(5):e725.CrossRefGoogle Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. APA Press, 2013.Google Scholar
Arena, JE, Rabinstein, AA. Transient global amnesia. Mayo Clin Proc 2015;90(2):264272.CrossRefGoogle ScholarPubMed
Balestreri, M, Szonskya, M, Chatfield, DA, et al. Predictive value of the Glasgow Coma Scale after brain trauma: change in trend over the past ten years. J Neurol Neurosurg Psych 2004;75:161162.Google ScholarPubMed
Bartsch, T, Butler, C. Transient amnesic syndromes. Nature Rev Neur 2013;9:8697.CrossRefGoogle ScholarPubMed
Brown, J. ED Evaluation of transient global amnesia. Ann Emerg Med 1997;30(4):522526.CrossRefGoogle ScholarPubMed
Carpenter, CR, DesPain, B, Keeling, TN, et al., The Six-Item Screener and AD8 for the detection of cognitive impairment in geriatric emergency department patients. Ann Emerg Med 2011;57(6):653661.CrossRefGoogle ScholarPubMed
Doebbeling, CC. Behavioral emergencies. In Merck Manuals Professional Edition. 2008. Available at www.merckmanuals.com/professional/psychiatric-disorders/approach-to-the-patient-with-mental-symptoms/behavioral-emergencies. Accessed June 5, 2018.Google Scholar
Edlow, JA, Rabinstein, A, Traub, SJ, Wijdicks, EF. Diagnosis of reversible causes of coma. Lancet 2014;384:20642076.CrossRefGoogle ScholarPubMed
Fong, T, Davis, D, Growdon, MA, et al. The interface between delirium and dementia in elderly adults. Lancet 2015. http://dx.doi.org/10/1016/S1474-4411(15)00101-5.Google Scholar
Greer, DM, Yang, J, Scripko, PD, et al., Clinical examination for outcome prediction in nontraumatic coma. Crit Care Med 2012;40:11501156.CrossRefGoogle ScholarPubMed
Horsting, MWB, Franken, MD, Meulenbelt, J, et al. The etiology and outcome of non-traumatic coma in critical care: a systematic review. BMC Anesthesiol 2015;15:6572.CrossRefGoogle ScholarPubMed
Inouye, SK, Westendrop, RG, Saczynski, JS. Delirium in elderly people. Lancet 2014;383:911922.CrossRefGoogle ScholarPubMed
Kales, HC, Gitlin, LN, Lyketsos, CG. Assessment and management of behavioral and psychological symptoms of dementia. BMJ 2015;350:h369.CrossRefGoogle ScholarPubMed
Kalish, VB, Gillham, JE, Unwin, BK. Delirium in older persons: evaluation and management. Am Fam Phys 2014;90(3):150158.Google ScholarPubMed
Knopman, DS, DeKosky, ST, Cummings, JL, et al. Practice parameter: diagnosis of dementia. An evidence based review. Neurology 2001;56:11431153.CrossRefGoogle ScholarPubMed
Moore, SA, Wijdicks, EF. The acutely comatose patient: clinical approach and diagnosis. Sem Neurol 2013;33:110120.CrossRefGoogle ScholarPubMed
Saitman, A, Park, H-D, Fitzgerald, RL. False-positive interferences of common urine drug screen immunoassays: a review. J Anal Toxicol 2014;38(7):387396.CrossRefGoogle ScholarPubMed
Samaras, N, Chevalley, T, Samaras, D. et al. Older patients in the emergency department: a review. Ann Emerg Med 2010;56(3):261269.CrossRefGoogle ScholarPubMed
Scheel, M, Malkowsky, C, Klingebiel, et al. Magnetic resonance imaging in transient global amnesia. Clin Neurorad 2012;22:335340.CrossRefGoogle ScholarPubMed
Tokuda, Y, Nakazato, N, Stein, GH. Pupillary evaluation for differential diagnosis of coma. Postgrad Med J 2003;79:4951.Google Scholar
Weisberg, LA, Garcia, C, Strub, R. Stupor and coma. In Essentials of Clinical Neurology. 2015. Available at: http://tulane.edu/som/departments/neurology/programs/clerkship/essentials-clinical-neurology.cfm. Accessed August 15, 2015.Google Scholar
Wijdicks, EFM, Bamlet, WR, Maramattom, BV et al. Validation of a new coma scale: the FOUR score. Ann Neurol 2005;58(4):585593.CrossRefGoogle ScholarPubMed
Wilber, ST, Lofgren, SD, Mager, TG et al. An evaluation of two screening tools for cognitive impairment in older emergency department patients. Acad Emerg Med 2005;12:612616.CrossRefGoogle ScholarPubMed
Wong, CL, Holroyd-Leduc, J, Simel, DL, Straus, SE. Does this patient have delirium? JAMA 2010;304:779786.Google Scholar

Bibliography

Anthony, M, Daher, BN. Mechanism of action of steroids in cluster headache. In Clifford, RF (ed.) New Advances in Headache Research 2. Smith Gordon, 1992.Google Scholar
Backes, D, Rinkel, GJ, Kemperman, H, Linn, FH, Vergouwen, MD. Time-dependent test characteristics of head computed tomography in patients suspected of nontraumatic subarachnoid hemorrhage. Stroke 2012;43(8):21152119.CrossRefGoogle ScholarPubMed
Barton, CW Evaluation and treatment of headache patients in the emergency department: a survey. Headache 1994;34:9194.CrossRefGoogle ScholarPubMed
Bigal, ME, Bordini, CA, Tepper, SJ, Speciali, JG. Intravenous magnesium sulphate in the acute treatment of migraine without aura and migraine with aura: a randomized double-blind placebo-controlled study. Cephalalgia 2002;22(5):345353.CrossRefGoogle ScholarPubMed
Bigal, ME, Bordini, CA, Speciali, JG. Intravenous chlorpromazine in the emergency department treatment of migraines: a randomized controlled trial. J Emerg Med 2002;23(2):141148.CrossRefGoogle ScholarPubMed
Bigal, ME, Lipton, RB. Excessive opioid use and the development of chronic migraine. Pain 2009;142(3):179182.CrossRefGoogle ScholarPubMed
Cete, Y, Dora, B, Ertan, C, Ozdemir, C, Oktay, C. A randomized prospective placebo-controlled study of intravenous magnesium sulphate vs. metoclopramide in the management of acute migraine attacks in the Emergency Department. Cephalalgia 2005;25(3):199204.CrossRefGoogle ScholarPubMed
Demirkaya, S, Vural, O, Dora, B, Topcuoglu, MA. Efficacy of intravenous magnesium sulfate in the treatment of acute migraine attacks. Headache 2001;41(2):171177.CrossRefGoogle ScholarPubMed
Dodick, DW, Capobianco, DJ. Treatment and management of cluster headache. Curr Pain Headache Rep 2001;5:8391.CrossRefGoogle ScholarPubMed
Dougherty, CO, Marmura, MJ, Ergonul, Z, Charleston, LC, Szperka, CL. Emergency and inpatient treatment of migraine: an American Headache Society survey. Brit J Med Med Res 2014;4(20):38003813.CrossRefGoogle Scholar
Ekbom, K Treatment of acute cluster headache with sumatriptan. N Engl J Med 1991;325:322326.Google Scholar
Fogan, L Treatment of cluster headache: a double-blind comparison of oxygen vs air inhalation. Arch Neurol 1985;42:362363.Google Scholar
Frank, LR, Olson, CM, Shuler, KB, Gharib, SF. Intravenous magnesium for acute benign headache in the emergency department: a randomized double-blind placebo-controlled trial. CJEM 2004;6(5):327332.CrossRefGoogle ScholarPubMed
Ginder, S, Oatman, B, Pollack, M. A prospective study of i.v. magnesium and i.v. prochlorperazine in the treatment of headaches. J Emerg Med 2000;18(3):311315.Google Scholar
Grosberg, BM, Solomon, S Recognition and treatment of cluster headache in the emergency department. Curr Pain Headache Rep 2004;8:140146.Google Scholar
Kostic, MA, Gutierrez, FJ, Rieg, TS, Moore, TS, Gendron, RT. A prospective, randomized trial of intravenous prochlorperazine versus subcutaneous sumatriptan in acute migraine therapy in the emergency department. Ann Emerg Med 2010;56(1):16.Google Scholar
Orr, SL, Aube, M, Becker, WJ, et al. Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings. Cephalalgia 2014;35(3):271284.Google Scholar
Raskin, NH. Repetitive intravenous dihydroergotamine as therapy for intractable migraine. Neurology. 1986;36:995997.CrossRefGoogle ScholarPubMed
Saper, JR, Silberstein, SD, Gordon, CD, Hamel, RL (eds.). Handbook of Headache Management. Williams & Wilkins, 1993.Google Scholar
Saper, JR, Lake III, AE. Continuous opioid therapy (COT) is rarely advisable for refractory chronic daily headache: limited efficacy, risks, and proposed guidelines. Headache 2008;48(6):838849.Google Scholar
Schwartz, TH, Karpitskiy, VV, Sohn, RS. Intravenous valproate sodium in the treatment of daily headache. Headache 2002;42(6):519522.Google Scholar
Somerville, BW. Treatment of migraine attacks with an analgesic combination (Mersyndol). Med J Aust 1976;1(23):865866.CrossRefGoogle ScholarPubMed
Swidan, SZ, Lake III, AE, Saper, JR. Efficacy of intravenous diphenhydramine versus intravenous DHE-45 in the treatment of severe migraine headache. Curr Pain Headache Rep 2005;9(1):6570.CrossRefGoogle ScholarPubMed

Bibliography

Andrus, P Michael Guthrie, J. Acute peripheral neurologic lesions. In Tintinalli, JE, (ed.) Tintinalli’s Emergency Medicine, 7th ed. McGraw-Hill, 2011.Google Scholar
Asimos, AW. Evaluation of the adult with acute weakness in the emergency department. Available at: www.uptodate.com/home.index.html. 2015Google Scholar
Donaghy, M. Brain’s Diseases of the Nervous System, 10th ed. Oxford University Press, 2002.Google Scholar
Dyck, P, Thomas, P. K. (eds.). Peripheral Neuropathy, 3rd ed. W. B. Saunders, 1993.Google Scholar
Engel, AG, Franzini-Armstrong, C (eds.). Myology, 2nd ed. McGraw-Hill, 1994.Google Scholar
Fernández-Frackelton, M. Bacteria. In Marx, J (ed.) Rosen’s Emergency Medicine, 8th ed. W. B. Saunders, 2013.Google Scholar
Fuchs, S. Weakness. In Schafermeyer, R (ed.) Strange and Schafermeyer’s Pediatric Emergency Medicine, 4th ed. McGraw-Hill, 2014.Google Scholar
Handel, DA, Gaines, SA. Chronic neurological disorders. In Tintinalli, JE (ed.) Tintinalli’s Emergency Medicine, 7th ed. McGraw Hill, 2011.Google Scholar
Lewis, ED, Mayer, SA, Noble, JM (eds.). Merritt’s Neurology, 10th ed. Lippincott Williams and Wilkins Publishers, 2000.Google Scholar
Miller, ML Approach to the patient with muscle weakness. 2015. Available at: www.uptodate.com/home.index.html.Google Scholar
Sethi, RK, Thompson, LL. The Electromyographer’s Handbook, 2nd ed. Little Brown and Company, 1989.Google Scholar
Stone, KC. Neurologic emergencies. In Stone, KC (ed.) Current Diagnosis and Treatment Emergency Medicine, 7th ed. McGraw Hill, 2011.Google Scholar
Swanson, PD. Signs and Symptoms in Neurology. Lippincott, 1984.Google Scholar

Bibliography

Ahn, UM, Ahn, NU, Buchowski, JM, et al. Cauda equine syndrome secondary to lumbar disc herniation: a meta-analysis of surgical outcomes. Spine 2000;25(12):15151522.Google Scholar
American Society of Anesthesiologists Task Force on Neuroaxial Opioids, Horlocker, TT, Burton, AW, et al. Practice guidelines for the prevention, detection, and management of respiratory depression associated with neuraxial opioid administration. Anesthesiology 2009;110:218230.Google ScholarPubMed
Arnold, PM, Harsh, V, Oliphant, SM. Spinal cord compression secondary to intrathecal catheter-induced granuloma: a report of four cases. Evid Based Spine Care J 2011;2(1):5762.Google Scholar
Baker, K. Chronic pain syndromes in the emergency department: identifying guidelines for management. Emerg Care Australia 2005;17:5764.Google ScholarPubMed
Bauman, BH, McManus, JG. Pediatric pain management in the emergency department. Emerg Med Clin North Am 2005;23:393414.CrossRefGoogle ScholarPubMed
Dillard, J, Knapp, S. Complementary and alternative pain therapy in the emergency department. Emerg Med Clin North Am 2005;23:529549.Google Scholar
Ducharme, J. The future of pain management in emergency medicine. Emerg Med Clin North Am 2005;23:467475.CrossRefGoogle ScholarPubMed
Fosnocht, DE, Swanson, ER, Barton, E. Changing attitudes about pain and pain control in emergency medicine. Emerg Med Clin North Am 2005;23:297306.CrossRefGoogle ScholarPubMed
Gilmer-Hill, H, Boggan, JE, Smith, KA, et al. Intrathecal morphine delivered via subcutaneous pump for intrathecal cancer pain: a review of the literature. Surg Neurol 1999;51:1215.CrossRefGoogle ScholarPubMed
Hansen, G. Management of chronic pain in the acute care setting. Emerg Med Clin North Am 2005;23:307338.Google Scholar
Hassenbusch, S, Burchiel, K, Coffey, RJ, et al. Management of intrathecal catheter-tip inflammatory masses: a consensus statement. Pain Med 2002;3(4):313323.CrossRefGoogle ScholarPubMed
Lawrence, L. Legal issues in pain management: striking the balance. Emerg Med Clin North Am 2005;23:573584.Google Scholar
Motov, SM, Khan, , Problems and barriers of pain management in the emergency department: are we going to get better? J Pain Res 2009;2:511.Google Scholar
Motov, SM, Marshall, JP. Acute pain management curriculum for emergency medicine residency programs. Acad Emerg Med 2011;18:S87S91.CrossRefGoogle ScholarPubMed
Perrone, J, Mycyk, MB, A challenging crossroads for emergency medicine: the epidemics of pain and pain medication deaths. Acad Emerg Med 2014;21:334336.Google Scholar
Prager, J, Deer, T, Levy, R, et al. Best practices for intrathecal drug delivery for pain. Neuromodulation 2014;17:354372.CrossRefGoogle ScholarPubMed
Richards, C. Establishing an emergency department pain management system. Emerg Med Clin North Am 2005;23:519527.CrossRefGoogle ScholarPubMed
Ross, JC, Cook, AM, Steward, GL, et al. Acute intrathecal baclofen withdrawal: a brief report of treatment options. Neurocrit Care 2011;14(1):103108.Google Scholar
Santana, L, Quintero, M. Management baclofen withdrawal syndrome. Rev Columb Anesthesiol 2012;40(2):158161.Google Scholar
Smith, HS, Deer, TR, Staats, PS, et al. Intrathecal drug delivery. Pain Phys 2008;11:S89S104.Google Scholar
Thomas, S. Management of pain in the emergency department. ISRN Emerg Med 2013;23:119.CrossRefGoogle Scholar
Todd, K. Treating chronic pain patients in the emergency department. ACEP News, 2008.Google Scholar
Tomycz, ND, Ortiz, V, McFadden, KM, et al. Management of symptomatic intrathecal catheter-associated masses. Clin Neurol Neurosurg 2012;114(2):190195.Google Scholar
Venkat, A, Fromm, C, Isaacs, E, Ibarra, J. An ethical framework for the management of pain in the emergency department. Acad Emerg Med 2013;20:716723.Google Scholar

Bibliography

Chen, R, Su, R, Deng, M, et al. A posterior circulation ischemia risk score system to assist the diagnosis of dizziness. J Stroke Cerebrovasc Dis 2018;27(2):506512.Google Scholar
Cheung, CS, Mak, PS, Manley, KV, et al. Predictors of important neurological causes of dizziness among patients presenting to the emergency department. Emerg Med J 2010;27(7):517521.Google Scholar
Choi, JH, Oh, EH, Park, MG, et al. Early MRI-negative posterior circulation stroke presenting as acute dizziness. J Neurol 2018;265(12):29933000.Google Scholar
Crespi, V. Dizziness and vertigo: an epidemiological survey and patient management in the emergency room. Neurol Sci 2004;25(1):S24S25.Google Scholar
Edlow, JA, Gurley, KL, Newman-Toker, DE. A new diagnostic approach to the adult patient with acute dizziness. J Emerg Med 2018;54(4):469483.CrossRefGoogle Scholar
Epley, JM. The canalith repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg 1992;107(3):399404.Google Scholar
Kattah, JC, Talkad, AV, Wang, DZ, Hsieh, YH, Newman-Toker, DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke 2009;40(11):35043510.Google Scholar
Kerber, KA. Vertigo and dizziness in the emergency department. Emerg Med Clin North Am 2009;27(1):3950.CrossRefGoogle ScholarPubMed
Kerber, KA, Newman-Toker, DE. Misdiagnosing dizzy patients: common pitfalls in clinical practice. Neurol Clin 2015;33(3):565575.CrossRefGoogle ScholarPubMed
Lammers, W, Folmer, W, Van Lieshout, EM, et al. Demographic analysis of emergency department patients at the Ruijin Hospital, Shanghai. Emerg Med Int 2011;2011:748274.Google Scholar
Martin-Schild, S, Albright, KC, Tanksley, J, et al. Zero on the NIHSS does not equal the absence of stroke. Ann Emerg Med 2011;57(1):4245.Google Scholar
Navi, BB, Kamel, H, Shah, MP, et al. Application of the ABCD2 score to identify cerebrovascular causes of dizziness in the emergency department. Stroke 2012;43(6):14841489.Google Scholar
Navi, BB, Kamel, H, Shah, MP, et al. Rate and predictors of serious neurologic causes of dizziness in the emergency department. Mayo Clin Proc 2012;87(11):10801088.CrossRefGoogle ScholarPubMed
Newman-Toker, DE, Cannon, LM, Stofferahn, ME, et al. Imprecision in patient reports of dizziness symptom quality: a cross-sectional study conducted in an acute care setting. Mayo Clin Proc 2007;82(11):13291340.CrossRefGoogle Scholar
Oppenheim, C, Stanescu, R, Dormont, D, et al. False-negative diffusion-weighted MR findings in acute ischemic stroke. AJNR Am J Neuroradiol 2000;21(8):14341440.Google Scholar
Parnes, LS, Price-Jones, RG. Particle repositioning maneuver for benign paroxysmal positional vertigo. Ann Otol Rhinol Laryngol 1993;102(5):325331.CrossRefGoogle ScholarPubMed
Schneck, MJ. Current stroke scales may be partly responsible for worse outcomes in posterior circulation stroke. Stroke 2018;49(11):25652566.Google Scholar
Smith, DB. Dizziness: a clinical perspective. In Kaufman, AI, Smith, DB (eds.) Neurologic Clinics: Diagnostic Neurotology. W. B. Saunders, 1990.Google Scholar
Tintinalli, J, Ma, OJ, Yealy, D, et al. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 9th ed. McGraw-Hill, 2019.Google Scholar

Bibliography

Ropper, AH, Samuels, MA, Klein, J, Prasad, S (eds.). Adams and Victor’s Principles of Neurology, 11th ed. McGraw-Hill, 2019.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×