Neurology: A Clinical Handbook

Description

“This Handbook is a sparkling addition to the neurological library, a concise and clear guide to clinical practice in neurology, written in elegant prose, a tribute to Queen Square and to the contribution that both Hospital and Institute have made to neurology. It is the encapsulation of wisdom gained in a long career. For practitioners in the art of neurology, junior and senior this is required reading." --Simon Shorvon, National Hospital for Neurology & Neurosurgery, Queen Square Neurology: A Clinical Handbook is a practical text, for both neurologists and general physicians, in the wards, the office or at home. This book spans the breadth of neurology and its challenges, for those who require a rapid resource in accessible language. The Handbook is also aimed at those considering entering neurology, neurophysiology and neurorehabilitation and for medical trainees and consultants in many specialities. It is an invaluable source for the MRCP, a ready-made reference for clinical practice and for the specialist nurse and therapist. The book deals with essentials - of neuroanatomy, clinical examination, mechanisms of neurological disease and the major issues of dementia and stroke in an ageing population. More specific aspects of neurology are also addressed, including the specialist fields of nerve and muscle disease, the spinal cord, headache and the cranial nerves, infection in the nervous system, MS and sleep disorders. The allied disciplines of neurorehabilitation, neuropsychiatry, neuro-oncology, uro-neurology, neuro-otology and neuro-ophthalmology are also covered. The aim is to provide both an introduction and a summary - of general neurological practice and the specialist aspects of neurology and neuroscience. ABOUT THE AUTHOR Dr Charles Clarke has been a consultant neurologist since 1979 and has broad experience and interests throughout neurology. He worked at St Bartholomew's Hospital, the National Hospital for Neurology & Neurosurgery and in the front line of clinical practice at Whipps Cross Hospital, London and other district general hospitals. He has retired from the NHS and remains in practice. He was both the founding editor and an author of Neurology: A Queen Square Textbook, First and Second Edition. Cover Title Page Copyright Page Contents Preface Foreword Chapter 1 Neurology Worldwide: Public Health and Essential Neuro-epidemiology Basic Data Practical Neurology Causation Mortality, Life Expectancy and Quality of Life Burden of Illness Cost of Illness Studies Improvements Acknowledgements References Further Reading and Information Chapter 2 Movement, Sensation and The Silent Brain ABC of Movement: Cortical, Extrapyramidal and Cerebellar Function Cortex: Movement Force, Direction and Synergy Pyramidal System Anatomy Extrapyramidal System and Basal Ganglia Region Cerebellar System Sensory Pathways Sensory Pathways in the Cord and Brain The Silent Brain Brainstem Reticular Formation Limbic System and Hippocampus Thalamus Hypothalamus and Pituitary Acknowledgements Further Reading and Information Chapter 3 Aetiologies and Mechanisms: Genetics, Immunology and Ion Channels Genetics Essential Embryology of the Spine Chromosomal Abnormalities, Repeat Expansions and Mutations Immune Mechanisms: Concepts and Components Blood–Brain and Blood–Nerve Barriers Immune Nervous System Diseases T-Cell-Mediated Neurological Disease Immunomodulation, Immunosuppression and Replacement Therapy Targeted Ablative Therapies Ion Channels and Inherited Mutations Migraine, Epilepsy, Movement Disorders and Ataxias Disease Causation Acknowledgements Further Reading Chapter 4 Examination, Diagnosis and the Language of Neurology Elements of Diagnosis History Nature of Symptoms Neurological Examination: Preliminary Assessment Brief Neurological Examination Detailed Examination Sensory System Formulation Diagnostic Tests Imaging Clinical Neurophysiology Specialised Investigations Cerebrospinal Fluid Examination Biopsy: Brain, Nerve and Muscle Neuropsychological Testing The Vocabulary of Neurology Focal Cortical Disorders Motor Abnormalities: Brain and Spinal Cord Hemiparesis Cerebellar Syndromes Movement Disorders Paraparesis Brainstem Syndromes Anterior Horn Cell Disease Sensory Abnormalities: Patterns at Different Levels Peripheral Nerve Lesions Polyneuropathy Sensory Root and Root Entry Zone Cord Lesions: Sensory Changes Brainstem Lesions and Sensation Thalamic Lesions Mononeuropathy, Polyneuropathy Neurogenic Muscle Wasting Root Lesions Myopathy Abnormal Illness Behaviour and Somatic Symptom Disorder Acknowledgements References Further Reading Chapter 5 Cognition, Cortical Function and Dementias Cognitive Functions and Clinical Practice Attention and Neglect Memory – Its Subdivisions Anatomy Amnesias Paramnesias Perception and Its Disorders Hallucinations – False Perceptions Voluntary Action Failure: Apraxias Speech and Language Reading, Writing and Numeracy Reading Writing Numeracy Knowledge and the Cognitive Executive Emotion Dementias Investigation of dementia Alzheimer’s Disease Clinical Features Frontotemporal Dementia Prion Diseases Dementia in Young Adults Controversial Entities Management of Dementia Acknowledgements Further Reading Websites Broca’s aphasia Wernicke’s aphasia Chapter 6 Stroke and Cerebrovascular Disease Pathophysiology: Ischaemic Stroke Thrombosis, Embolism, Collaterals and the Ischaemic penumbra Metabolic Changes and Raised Intracranial Pressure Risk factors: Age, Hypertension, Tobacco, Lipids, Alcohol Cardiac Disease Ischaemic Stroke and the Blood Stroke and TIA Transient Ischaemic Attack (TIA) Typical Stroke Patterns Internal Carotid Artery (ICA) Disease Total and Branch Middle Cerebral Artery (MCA) Occlusion Anterior Cerebral (ACA) and Posterior Cerebral Artery (PCA) Occlusion Vertebral Artery Basilar Artery Border Zone Ischaemia Vascular Dementia Intracerebral Haemorrhage (ICH) Deep Haemorrhage Stroke & TIA management NICE Guidance: Stroke & TIA – Diagnosis and Initial Management Stroke and TIA Investigations Progressive Stroke Clinical Features: Thunderclap Headache Investigation and Management SAH Complications, Treatment & Outcome Cerebral Venous and Venous Sinus Thrombosis Imaging, Treatment and Outcome Arteriovenous Malformations Cavernous Malformations Non-atherosclerotic Vascular Disease and Other Causes of Stroke Carotid and Vertebral Artery Dissection Vasculitis and Other Rarities Infective Vasculitis Hypertensive Encephalopathy and Eclampsia Migraine and Stroke Moyamoya Angiopathy Reversible Cerebral Vasoconstriction and Posterior Reversible Encephalopathy Syndromes (RCVS & PRES) Acknowledgements Further Reading Personal References Websites Chapter 7 Movement Disorders Parkinsonian Syndromes and Parkinsonism Parkinsonism: Motor Features Parkinson’s Disease PD: Premotor Features PD: Typical Motor Presentation PD: Non-motor Features Investigations PD Treatment: Levodopa + DDIs: Madopar and Sinemet Parkinson’s, Dementia and Lewy Body Pathology Multiple System Atrophy (MSA) Progressive Supranuclear Palsy (PSP) Corticobasal Degeneration Investigations: MSA, PSP, CBD Tremor Benign Essential Tremor (ET) Dystonic Tremor and Tremor Associated with Dystonia Neuropathic Tremor and Fragile X Tremor Ataxia Syndrome (FXTAS) Cerebellar (Pathway) Tremor and Holmes Tremor Palatal Tremor Orthostatic Tremor Drug, Metabolic, Toxin-Induced Tremors and Functional Tremor Dystonia Primary Generalised Dystonia Chorea Huntington’s Disease Neuro-Acanthocytoses Post-Streptococcal Autoimmune Disorders Benign Hereditary Chorea Drug-Induced Chorea Chorea: Drug Management Tics Gilles de la Tourette Syndrome Other Tic Disorders Management of Tics Myoclonus and Startle Syndromes Functional Movement Disorders Movement Disorders and Dopamine Receptor Blockade Restless Legs Syndrome and Painful Legs and Moving Toes Stiff Person and Stiff Limb Syndromes Fatal Encephalomyelitis with Rigidity Acknowledgements Further Reading Websites Chapter 8 Epilepsy and Related Disorders International League Against Epilepsy Classification Simple and Complex Partial Seizures Generalised Seizures Classification and Causes of Epilepsy Single-Gene and Other Disorders Hippocampal Sclerosis and Perinatal Disorders Trauma Tumours and Neurosurgery Infection Cerebrovascular Degenerative Immune-Mediated Provoked and Reflex Epilepsies Differential Diagnosis Loss of Awareness Generalised Movements - Epilepsy and Non-Epileptic Attack Disorder (NEAD) Focal Seizures, Tics, TIAs, MS, Movement Disorders Drop Attacks Focal Sensory, Visual and Vestibular Symptoms Transient Psychological Experiences Aggressive Outbursts and Criminal Activity Sleep Phenomena Prolonged Confusional and Fugue States Intermittent Psychosis and Fugues Investigation EEG in Epilepsy Diagnosis – Epileptiform and Normal Phenomena Imaging Management: Newly Diagnosed Cases Management: Established Epilepsy Antiepileptic Drugs Emergencies: Prolonged Convulsions, Serial Seizures, Status Epilepticus Treatment Epilepsy Surgery Driving Regulations: UK Acknowledgements Further Reading Websites Chapter 9 Infections Acute Bacterial Meningitis The Meningitic Syndrome Management Neisseria Meningitidis Streptococcus Pneumoniae Brain Abscess Subdural Empyema Intracranial Epidural Abscess Spinal Epidural, Subdural and Intramedullary Abscess Infective Endocarditis: Neurology Tuberculosis Tuberculoma, TB Brain Abscess and Spinal TB Leprosy (Hansen’s Disease) Syphilis and Neurosyphilis (Treponema pallidum pallidum) Lyme Disease and Neuroborreliosis Leptospirosis (Weil’s Disease) Brucellosis (Malta Fever, Undulant Fever) Psitticosis and Cat Scratch Disease Anthrax Diphtheria Botulism Tetanus Whipple’s Disease Tick-Borne Diseases Other Infections Viral Infections Varicella Zoster Virus: Chickenpox and Shingles Viral Meningitis Viral Encephalitis Herpes Simplex Encephalitis Japanese Encephalitis and Viral Haemorrhagic Fevers Poliomyelitis Subacute Sclerosing Panencephalitis (SSPE) Rabies HTLV-1 Epstein–Barr Virus (EBV) COVID-19 Fungal Infections Parasitic Worms Schistosomiasis (Bilharzia) and Other Parasitic Worms African Trypanosomiasis (Sleeping Sickness) American Trypanosomiasis (Chagas Disease) Malaria Toxoplasmosis HIV Acknowledgements Further Reading Chapter 10 Nerve, Anterior Horn Cell and Muscle Disease Peripheral Nerve Anatomy Inherited Neuropathies Charcot–Marie–Tooth Disease(s) and Related Disorders Inflammatory and Acquired Neuropathies Guillain–Barré Syndrome and GBS Variants Chronic Inflammatory Demyelinating Polyradiculoneuropathy and CIPD Variants Focal and Compressive Neuropathies Upper Limb Lower Limb Chronic Neuropathies with Paraproteinaemias Vasculitic Neuropathies Small Fibre Neuropathies (SFNs) Plexopathies Acute Brachial Neuritis a.k.a. Neuralgic Amyotrophy Anterior Horn Cell Diseases Motor Neurone Disease Spinal Muscular Atrophies (SMAs) Kennedy’s Disease (X-Linked Spinobulbar Muscular Atrophy) Neuromuscular Junction Disorders Myasthenia Gravis Lambert–Eaton Myasthenic Syndrome (LEMS) Muscle Diseases Assessment and Investigation Genetic Muscle Diseases Muscular Dystrophies Dystrophinopathies: Xp21 Dystrophies – Duchenne and Becker Myotonic Dystrophies (Dystrophia myotonica, DM1 and DM2) Skeletal Muscle Channelopathies: Periodic Paralyses and Myotonias Mitochondrial Respiratory Chain Diseases Glycogen and Lipid Storage Myopathies Inflammatory Myopathies, Rarities, Drugs and Rhabdomyolysis Dermatomyositis Polymyositis Inclusion Body Myositis Rarities Drugs and Myopathies Rhabdomyolysis Acknowledgements Further Reading and Websites Chapter 11 Multiple Sclerosis, Neuromyelitis Optica (Devic’s) and Other Demyelinating Diseases Multiple Sclerosis Aetiology, Migration, Genetics and Environment Pathology Types of MS: Clinical Course MS Classifications and Criteria Natural History, Prognosis and Mortality Clinical Features Diagnosis and Investigations Management Relapse Management Neuromyelitis Optica, Devic’s Disease Epidemiology and Pathophysiology Clinical Features and Investigations Course, Natural History and Management Acute Parainfectious Inflammatory Encephalopathies Acute Disseminated Encephalomyelitis Acute Haemorrhagic Leukoencephalitis Acknowledgements Further Reading, References and Websites Chapter 12 Headache Classification and Anatomical Concepts Primary Headaches Migraine Management Tension-type Headache Trigeminal Autonomic Cephalalgias (TACS) Other Primary Headaches with Secondary Variants Secondary Headaches Medication Overuse Headache (MOH) and Withdrawal Headache Headache and Vascular Disorders Intracranial Mass Lesion Headache with High or Low Intracranial Pressure Headaches and Head Trauma Infection and Other Disorders Acknowledgements Further Reading, References and Websites Chapter 13 Cranial Nerve Disorders I. Olfactory Nerve Functional Anatomy Examination Olfactory Disorders V. Trigeminal Nerve Peripheral V Nerve Lesions Superior Orbital Fissure Syndrome Cavernous Sinus Syndrome Nuclear V lesions Trigeminal Neuralgia Aetiology, Pathogenesis and Management Trigeminal Idiopathic Sensory Neuropathy and Somatisation Herpes Zoster Ophthalmicus (HZO) Atypical Facial Pain VII. Facial Nerve Examination Cerebellopontine Angle (CPA) Syndrome A Canal Lesion or Distal to Stylomastoid Foramen Bell’s Palsy Melkersson–Rosenthal Syndrome Bilateral Facial Weakness Hemifacial Spasm Other Involuntary Facial Movements Progressive Hemifacial Atrophy Lower Four Cranial Nerves: IX, X, XI and XII IX. Glossopharyngeal Nerve X. Vagus Nerve XI. Accessory Nerve XI Nerve Damage XII. Hypoglossal Nerve Bulbar and Pseudobulbar Palsy Multiple Cranial Neuropathies Cranial Epidural Abscess Acknowledgements Further Reading and Information Chapter 14 Neuro-Ophthalmology Visual Pathways Retina and Optic Nerve Optic Chiasm, Optic Tract and Radiation Occipital Cortex Cortical Eye Fields Gaze Centres in the Brainstem The Light Reflex: Pupil Constriction III, IV and VI Nerves and Nuclei Examination Visual Loss: Uni- and Bilateral Visual Failure Optic Nerve Disease Optic Neuropathy – the Wider Classification Retina and Optic Nerve Vascular Anatomy Central and Branch Retinal Artery Occlusion Central and Branch Retinal Vein Occlusion Arteritic Anterior Ischaemic Optic Neuropathy: Giant Cell Arteritis (GCA) Non-Arteritic Anterior Ischaemic Optic Neuropathy Posterior Ischaemic Optic Neuropathy Chronic Ischaemia and Slow Flow Retinopathy Tumours, Compressive and Infiltrative Optic Neuropathy Hereditary – AD Optic Atrophy and Leber’s Toxic, Nutritional, Radiation-Induced Optic Neuropathies and Trauma Swollen Disc(s) – Papilloedema Uveo-Meningitic Syndromes Phakomatoses Diplopia and Eye Movement Abnormalities Orbital Conditions and Ophthalmoplegia Orbital Inflammatory Syndromes Cavernous Sinus Thrombosis Caroticocavernous Fistulae Ocular Myopathies Palsies of III, IV and VI Nerves Oculomotor Nerve (III Nerve Palsy) Abducens (VI) and Trochlear (IV) Nerve Palsies Gaze and Central Eye Movements Saccades, Gaze Palsies and Oculogyric Crises Internuclear Ophthalmoplegia (INO) Skew Deviation, Ocular Tilt Reaction and Nystagmus Chiasmal and Retrochiasmal Visual Pathways Homonymous Hemianopia Visual Cortex and Visual Association Areas Pupil Abnormalities Complete and Relative Afferent Pupillary Defect Efferent Light Reflex Defects Acknowledgements Further Reading and Information Chapter 15 Neuro-Otology: Disorders of Balance and Hearing Essential Anatomy Afferents and Efferents Dizziness and Vertigo Assessment Nystagmus Varieties Jerk, Normal, Deliberate and Pendular Nystagmus Nystagmus with Central Lesions Vestibular Investigations Caloric Testing Vestibular Disorders Benign Paroxysmal Positional Vertigo Vestibular Neuritis Vestibular Migraine Management: Drugs and Physical Manoeuvres Particle Repositioning Procedures and CBT Ménière’s, Central Vestibular Dysfunction and Migraine Hearing Disorders Auditory Anatomy and Investigation Conductive Loss: Middle Ear and Tympanic Membrane Age Related and Genetic Hearing Loss Environmental, Trauma, Drug Related and Syndromic Hearing Loss Auditory Processing Disorder (APD) Hearing Loss: Management Acknowledgements Further Reading and Information Chapter 16 Spinal Cord and Spinal Column Disorders Emergencies Cervical Spine Degeneration and Pathology Lateral and Central Cervical Disc Protrusion Management of a Painful Cervical Root Lesion Cervical and Thoracic Spinal Surgery Lumbar and Sacrococcygeal Spine Lumbar Canal Stenosis Low Back Pain: Management Lumbar Disc Surgery and Fusion Paraparesis/Paraplegia, Myelitis, Transverse Myelitis and Myelopathy Metabolic Conditions Cord Vascular Disease Cord Infarction and Spinal Haemorrhage Cord Arteriovenous Malformations Cord Vascular Neoplasms Hereditary Spastic Paraparesis Spinal Infection Spine and Spinal Cord Major Trauma Acute Spinal Injury Management and Rehabilitation Whiplash Craniocervical Junction – Basilar Invagination and Atlantoaxial Disease Chiari Malformations and Os Odontoideum Craniocervical Junction Disorders Syringomyelia and Syringobulbia Rheumatological and Bone Disorders Rheumatoid Disease Spondyloarthropathies Paget’s Disease of Bone Spinal Dysraphism, Scoliosis and Kyphosis Other Rare Causes of Spinal Deformity Acknowledgements Further Reading and Information Chapter 17 Ataxias, Cerebellar Disorders and Related Conditions Acquired Ataxia Syndromes The Posterior Fossa Mass Lesion Acute Cerebellar Ataxia Progressive Ataxia with a Chronic or Subacute Course MS, Vascular and Inflammatory Disease Alcohol, Solvent Abuse and Acquired Metabolic Disorders Drugs, Heavy Metals and Physical Agents Others Late-Onset Cerebellar Degenerations Inherited Ataxia Syndromes Autosomal Recessive Ataxias Ataxia: Metabolic Causes Autosomal Dominant Cerebellar Ataxias Episodic Ataxia: Genetic Forms X-Linked Ataxias and Mitochondrial Ataxia Syndromes Congenital Ataxias Acknowledgement Further Reading and Information Chapter 18 Restorative Neurology, Rehabilitation and Brain Injury Key Aspects Restorative and Compensatory Approaches, Skill Learning and Task-Related Training Motor Disorders: Therapeutic Interventions Specific Problems Spasticity and Ataxia Pain Single Incident Brain Injury Stroke Traumatic Brain Injury Service Delivery Goal Setting Outcome Measurement Vocational Rehabilitation Acknowledgements Further Reading, References and Websites Chapter 19 Toxins, Physical Insults, Nutritional and Metabolic Disorders, Unregulated Drugs Heavy Metals, Chemicals and Natural Toxins Heavy Metals Solvents and Chemicals Natural Toxins Radiation Lightning and Electrical Shocks Lightning High-Voltage (>1000 V) and Low-Voltage Injuries Injury from Lightning and Electric Shock Heat Stroke Hypothermia, Frostbite and Non-Freezing Cold Injury Diving and Decompression Sickness (DCS) High Altitude: Acute Mountain Sickness, Cerebral and Pulmonary Oedema Space Travel Neurobiological Weapons Vitamin Deficiencies and Copper Deficiency Ethyl Alcohol Malignant Hyperthermia (MH) Neuroleptic Malignant Syndrome (NMS) Serotonin Syndrome and Tyramine Cheese Reaction Porphyrias Inherited Metabolic Disorders Unregulated/Illegal Drugs and Drug Abuse Stimulants Sedatives, Analgaesics and Tranquillisers MPPP, MPTP and Parkinsonism Hallucinogens Solvents, Fuels and Gases Acknowledgements, Further Reading and Personal References Chapter 20 Consciousness, Coma, Intensive Care and Sleep Definitions of Consciousness and Coma States of Impaired Consciousness Stupor and Coma: A Practical Approach Detailed Assessment Level of Consciousness: Glasgow Coma Scale Neurology Other Coma-Like States Neurological Intensive Care Severe Traumatic Brain Injury (TBI): General Principles Neurosurgical Aspects of Severe TBI Sleep and Its Disorders Sequence of Normal Sleep The Autonomic Nervous System and Sleep Regulation of Wakefulness and Sleep Sleep Disorders Insomnia Obstructive Sleep Apnoea/Hypopnoea Hypersomnias of Central Origin Parasomnias Sleep-Related Movement Disorders Other Sleep-Related Disorders Acknowledgements, Further Reading and Personal References Chapter 21 Neuro-Oncology Clinical Features Headache Seizures and Focal Deficits Brainstem/Cerebellar, Cognitive and Behavioural Symptoms Endocrine, Visual and Olfactory Symptoms Imaging Tumours: The Multidisciplinary Approach Neurosurgery Radiotherapy and Chemotherapy Classification and Grades Diffuse Astrocytomas and Oligodendroglial Tumours Surgery, Radiotherapy and Chemotherapy Other Astrocytic Tumours Meningiomas Mesenchymal, Non-Meningothelial Tumours Lymphomas Germ Cell Tumours Tumours of the Sellar Region Pituitary Apoplexy Pituitary Tumour Management Craniopharyngioma Metastatic Brain and Spinal Tumours Primary Spinal Cord Tumours and Spinal Metastases Neurological Complications of Cancer (NCCs) Indirect and Secondary NCCs Acknowledgements, Further Reading and Websites Chapter 22 Neuropsychiatry Mental State Appearance and Behaviour Speech Mood and Affect Thought Thought Content Perceptions Cognition and Insight Formulation Mental Health and Capacity Acts Definitions and Diagnoses in Psychiatry Personality Disorders Obsessions and Compulsions Anxiety Mood Functional Neurological Disorders Functional: Terminology and Background Diagnosis of FNDs Dissociative Disorders Neurology and Psychiatry Epilepsy and Psychiatry Movement Disorders and Psychiatry Neuropsychiatry and Other Conditions Psychiatry and MS Acknowledgement and Further Reading Chapter 23 Pain Definitions Neuropathic Pain Mechanisms – Sodium and Calcium Channel Expression Pain in CNS Diseases MS, Non-paroxysmal, Paroxysmal and Nociceptive Pain Parkinson’s Disease, Dystonia/Dyskinesia Pain, PAF and MSA Central Post-Stroke Pain Spinal Cord Injury, Syringomyelia and MND Phantom Pain Painful Legs and Moving Toes Epilepsy Peripheral Pain Painful Peripheral Neuropathies Other Painful Conditions Pain Management Drug Treatments Psychological Approaches The Placebo Phenomenon Diminished Sensitivity to Pain Congenital Insensitivity to Pain Transient Indifference to Pain Acknowledgement and Further Reading Chapter 24 Autonomic Aspects of Neurology Anatomy and Neurotransmission Localised Autonomic Disorders Primary and Secondary Autonomic Disorders Syncope Orthostatic (Postural) Hypotension Orthostatic Intolerance with Posturally Induced Tachycardia (PoTS) Examination and Investigation Regional Autonomic Dysfunction Sudomotor: Anhidrosis and Hyperhidrosis Gut Kidneys and Urinary Tract Sexual Dysfunction Respiratory Hypertension and Cardiac Changes Parkinson’s Disease, Multiple System Atrophy (MSA) and Pure Autonomic Failure (PAF) Rare Autonomic Disorders Acknowledgements and Further Reading Chapter 25 Uro-Neurology and Sexual Dysfunction Lower Urinary Tract: Neurological Control Bladder Dysfunction and Neurological Disease Frontal Disease and Stroke Parkinson’s Disease Multiple System Atrophy Spinal Cord Disease MS and Peripheral Lesions Urinary Retention Urinary Retention in Women: Fowler’s Syndrome Management Storage Dysfunction: Simple Measures Investigations Other Measures and Drugs Sexual Function Sexual Dysfunction and Neurological Disease Spinal Cord Injury, MS and other Spinal Lesions Acknowledgememts, References and Further Reading Chapter 26 Systemic Conditions and Neurology Cardiac and Aortic Disease Cerebral Ischaemia and Aortic Disease Spinal Cord Ischaemia and Aortic Disease Cardiac Surgery: Neurological Complications Endocrine Disease Diabetes Mellitus Other Endocrine Disorders Electrolyte Disturbances Potassium, Calcium and Magnesium Blood Disorders Anaemias Leukaemias Plasma Cell Dyscrasias Lymphomas Langerhans Cell Histiocytosis Polycythaemia and Thrombocythaemia Thrombotic Thrombocytopenic Purpura and Bleeding Disorders Renal Disease Uraemic Encephalopathy Dialysis Encephalopathy Dialysis Disequilibrium Syndrome Neuropathy Associated with Renal Disease Malabsorption Inflammatory Bowel Disease Neurology and Transplantation Some Specific Complications Systemic Vasculitides and Related Disorders Pathological Mechanisms Sjögren’s Syndrome (SS) Other Cerebral Arteriopathies CADASIL CARASIL Fabry’s Disease Susac’s Syndrome Sneddon’s Syndrome Degos’ Disease Hereditary Angiopathy with Neuropathy, Aneurysms and Cramps (HANAC) Reversible Cerebral Vasoconstriction Syndrome (RCVS) and Posterior Reversible Encephalopathy Syndrome (PRES) Sarcoidosis Clinical Features Cranial Neuropathy Peripheral Neuromuscular Sarcoid Meningeal and Parenchymatous NS Diagnosis and Prognosis Behçet’s Syndrome Pathergy Test Treatment IgG4-Related Disease and CLIPPERS Neurocutaneous Syndromes Neurofibromatosis Types 1 and 2 Xeroderma Pigmentosum (XP) Tuberous Sclerosis (TS) Von Hippel–Lindau Disease (VHL) Ataxia Telangiectasia Sturge–Weber Syndrome Neurological Aspects of Pregnancy Epilepsy and Pregnancy Other Abnormalities and Neurodevelopmental Delay Pregnancy and Other Neurological Conditions Acknowledgements, References and Further Reading Index EULA