Neurology
Stroke, seizures, headache, neuropathy and neuromuscular disease.
- Stroke Anatomical classification with the Bamford criteria, the hyperacute pathway for thrombolysis and thrombectomy, and secondary prevention.
- Transient Ischaemic Attack Why the modern definition is tissue-based, the 24-hour urgent specialist pathway, and starting secondary prevention on day one.
- Subarachnoid Haemorrhage Recognising thunderclap headache, the 6-hour CT rule versus lumbar puncture for xanthochromia, and securing the aneurysm before rebleed or vasospasm.
- Subdural Haemorrhage Torn bridging veins, the crescent shape and age-dependent density on CT, and why chronic subdurals in older adults are easily missed.
- Extradural Haemorrhage The lucid interval as a trap rather than reassurance, the biconvex CT sign, and why speed to craniotomy determines survival.
- Cerebral Venous Sinus Thrombosis Why the presentation is more variable than arterial stroke, confirming it with venography, and anticoagulating even through a haemorrhagic infarct.
- Epilepsy and Seizures Classifying seizure type from the history, distinguishing epilepsy from syncope and PNES, and choosing antiepileptics safely in those who could become pregnant.
- Status Epilepticus Why the 5-minute threshold replaced the old 30-minute definition, and the staged benzodiazepine-to-anaesthesia treatment algorithm.
- Primary Headache Disorders Distinguishing migraine, tension-type and cluster headache by pattern, screening for secondary red flags, and recognising medication overuse headache.
- Trigeminal Neuralgia Recognising the touch-triggered electric-shock pattern, first-line carbamazepine, and when sensory loss or youth should prompt MRI instead.
- Idiopathic Intracranial Hypertension The modified Dandy criteria, why venous sinus thrombosis must be excluded first, and prioritising visual fields over headache severity.
- Raised Intracranial Pressure Using the Monro-Kellie doctrine to generate the differential, recognising the herniation syndromes, and why steroids only help tumour-related oedema.
- Multiple Sclerosis Diagnosing dissemination in time and space with the McDonald criteria, recognising optic neuritis and internuclear ophthalmoplegia, and disease-modifying therapy.
- Parkinson's Disease and Parkinsonism Distinguishing idiopathic PD from atypical parkinsonism by red flags, the levodopa trade-off, and why dopaminergic drugs must never be stopped abruptly.
- Essential Tremor Distinguishing postural/action tremor from a Parkinsonian rest tremor, and first-line treatment with propranolol or primidone.
- Motor Neurone Disease Recognising combined upper and lower motor neurone signs with spared sensation, riluzole's modest effect, and proactive multidisciplinary and respiratory care.
- Huntington Disease CAG repeat expansion and anticipation, the chorea-cognitive-psychiatric triad, and why suicide risk must be assessed at every stage.
- Myasthenia Gravis Eliciting fatigable weakness at the bedside, AChR/MuSK antibody testing, and recognising myasthenic crisis as a respiratory emergency.
- Guillain-Barre Syndrome Recognising post-infectious ascending weakness with areflexia, why FVC trumps oxygen saturation for monitoring, and IVIG/plasma exchange over steroids.
- Peripheral Neuropathy Classifying by distribution to generate the differential, why mononeuritis multiplex is a vasculitis red flag, and treating neuropathic pain.
- Autonomic Neuropathy Recognising diabetic autonomic failure across cardiovascular, GI and genitourinary systems, and why it can mask both angina and hypoglycaemia.
- Radiculopathy and Peripheral Nerve Palsies Localising a lesion to a root versus a named nerve by pattern, the L5-versus-common-peroneal foot drop trap, and cauda equina red flags.
- Muscular Dystrophies Recognising Gower's sign in Duchenne, myotonia and cataracts in myotonic dystrophy, and why cardiac surveillance matters regardless of limb weakness.
- Meningitis Why treatment must never wait for lumbar puncture, empirical antibiotic choice including Listeria cover, and interpreting CSF by cause.
- Encephalitis Why aciclovir starts on suspicion before CSF PCR confirms HSV, temporal lobe MRI changes, and recognising autoimmune encephalitis behind a psychiatric presentation.
- Brain Abscess Tracing the route of infection to the likely organism, the ring-enhancing lesion and its differential, and why lumbar puncture is contraindicated.
- Brain Tumours The four presenting syndromes, red flag headache features that warrant urgent MRI, and why metastases outnumber primary tumours in adults.
- Vestibular Schwannoma Why asymmetric sensorineural hearing loss demands an MRI, the eighth-fifth-seventh cranial nerve sequence, and choosing between observation, radiosurgery and resection.
- Spinal Cord Compression Why back pain precedes weakness and defines the treatment window, urgent whole-spine MRI, and starting dexamethasone before definitive treatment.
- Spinal Cord Injury Deriving the incomplete cord syndromes from tract anatomy, distinguishing spinal from neurogenic shock, and managing autonomic dysreflexia.
- Wernicke Encephalopathy and Korsakoff Syndrome Why the classic triad is usually incomplete, giving thiamine before glucose, and the narrow window before amnesia becomes permanent.
- Cranial Nerve Examination How to perform and present each component, the forehead-sparing and deviation rules, and localising from the pattern of nerves affected.