Common Neurological Disorders
High-Yield Conditions
Know the presentation, risk factors, and acute management of stroke, seizures, multiple sclerosis, Parkinson disease, meningitis, and increased intracranial pressure. Ischemic stroke presents with sudden focal deficits; time is brain, so recognize the thrombolytic window and the need for rapid imaging to exclude hemorrhage. Hemorrhagic stroke often presents with severe headache, vomiting, and hypertension.
Seizures: distinguish focal from generalized, and know that status epilepticus is a medical emergency requiring airway support and benzodiazepines. Multiple sclerosis shows relapsing-remitting demyelinating symptoms - optic neuritis, sensory changes, fatigue - often worse with heat (Uhthoff phenomenon). Parkinson disease features resting tremor, rigidity, bradykinesia, and postural instability; it is a dopamine-deficiency disorder.
Meningitis presents with fever, headache, neck stiffness, and photophobia; bacterial meningitis is an emergency requiring empiric antibiotics and droplet precautions. Increased intracranial pressure causes headache, vomiting, papilledema, and declining consciousness; manage with head elevation, avoiding hypoxia, and monitoring for herniation.
Traps
Stems confuse ischemic and hemorrhagic stroke management - thrombolytics are contraindicated in hemorrhage. Another trap asks the priority action in status epilepticus (airway and benzodiazepines, not an EEG). Watch for questions that mislabel Parkinson tremor as intention tremor (it is a resting tremor).
Rule of Thumb
"Sudden focal deficit = stroke until proven otherwise; fever plus stiff neck = meningitis until proven otherwise." Always prioritize airway and safety.