A Physiological Approach to Clinical Neurology - 1st Edition - ISBN: 9780407358508, 9781483163161

A Physiological Approach to Clinical Neurology

1st Edition

Authors: James W. Lance
eBook ISBN: 9781483163161
Imprint: Butterworth-Heinemann
Published Date: 1st January 1970
Page Count: 258
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Description

A Physiological Approach to Clinical Neurology deals with the mechanism of various neurological symptoms and signs in terms of disordered physiology. Topics covered by this book include pain and other sensations; weakness; the tendon jerk and the stretch reflex; and disordered control of motor neurons. The disorders of basal ganglia and cerebellum are also considered, along with consciousness and unconsciousness; the mechanism of epilepsy; and the relationship between brain and mind. This book is comprised of 11 chapters and begins by introducing the reader to the clinical analysis of sensory and motor disorders. The discussion then turns to the perception of pain and other kinds of sensation; the clinical approach to the problem of weakness; and the clinical significance of the tendon jerk. In the chapters that follow, appraisal of a neurophysiological thought is applied to common neurological disorders such as Parkinson's disease, hemiballismus, epilepsy, and developmental anomalies like platybasia. The last chapter explores the phenomena of mind and its connection to the brain as well as its influence on the body, paying particular attention to perception, memory, and emotion. This monograph is intended for those who are proceeding into the clinical years of a medical course, to those who are studying for senior qualifications in internal medicine or neurology, and to those who are merely curious about the cause of neurological phenomena that they observe daily in their patients.

Table of Contents


Preface

Acknowledgments

1-Pain and other Sensations

Sensory Symptoms

The Perception of Different Kinds of Sensation

Segregation or Integration of Neural Pathways?

Sensory Pathways in the Central Nervous System

The Perception of Pain

Visceral Pain

Referred Pain

Phenomena Associated with Pain

Common Patterns of Pain

Indifference or Insensitivity to Pain

Clinical History-Taking in Relation to Pain

The Interpretation of Sensory Symptoms and Signs

Principles of Management of Painful Syndromes

Summary

2-Weakness

Asthenia

Paralysis or Paresis

A Pure Pyramidal Lesion

An Upper Motor Neurone Lesion

Monoplegia, Hemiplegia, Paraplegia, Quadriplegia

The Lower Motor Neurone

The Neuromuscular Junction

Muscle

Metabolic Abnormalities

Hysterical Weakness

Transient Paralysis

The Clinical Approach to the Problem of Weakness

Summary

3-The Tendon Jerk; a Phasic Stretch Reflex

The Stretch Reflex

The Historical Importance of Decerebrate Rigidity

The Muscle Spindle

Afferent Fibers from Muscle

Phasic Muscle Reflexes

The H Reflex

The Tendon Jerk

The Clinical Significance of the Tendon Jerk

Summary

4—Tonic Stretch Reflexes: the Mechanism of Muscle Tone and Movement

Spinal Cord Influences on Tonic and Phasic Reflexes

Supraspinal Control of Motor Neurones

Reticulospinal Tracts

Vestibulospinal Tract

Other Extrapyramidal Tracts

Effects of Extrapyramidal Tracts on the Stretch Reflex

The Motor Cortex and Pyramidal Tract

The Tonic Stretch Reflex in Man

The Normal Control of Movement

Summary

5—Disordered Control of Motor Neurones

Frequency Control of Motor Neurones

Physiological or Action Tremor

Action Tremor and Alternating Tremor in Parkinson's Disease

The Mechanism of Physiological Tremor

Lesions of the Lower Motor Neurone

Lesions of the Upper Motor Neurone

Spasticity

The Extensor Plantar Response

Extrapyramidal (Parkinsonian) Rigidity

The Cogwheel Phenomenon

Phasic Stretch Reflex in Parkinson's Disease

Summary

6—The Basal Ganglia and their Disorders

The Extrapyramidal Motor System

Parkinson's Disease

The Nature of the Disturbance in Parkinson's Disease

Hemiballismus

Chorea

Athetosis

Dystonia

Summary

7—The Cerebellum and its Disorders

Developmental History

Anatomical Connexions

The Integrating Action of the Cerebellar Cortex

The Effect of the Cerebellum on Spinal Motor Systems

The Symptoms and Signs of Human Cerebellar Disease

Archicerebellar Syndrome

Palaeocerebellar Syndrome

Neocerebellar Syndrome

Disorders of the Cerebellum

Summary

8—Vertigo

The Vestibular System and its Connexions

The Syndrome of Vestibular Damage

Nystagmus

The Causes of Vertigo

History-Taking in Patients with Vertigo

Examination of Patients with Vertigo

Special Investigations

Caloric Tests of Vestibular Function

Electronystagmography

Hearing Tests

Diagnosis

Summary

9—Consciousness and Unconsciousness

The Ascending Reticular Activating System

The Source of Consciousness

Sleep—Loss of Consciousness

Clinical Examination of the Unconscious Patient

Common Causes of Coma

Summary

10—The Mechanism of Epilepsy

The Epileptic Neurone

The Hereditary Tendency to Epilepsy

Factors in Seizure Production

Factors in Seizure Prevention

The Mechanism of Seizures

Tonic Seizures

Focal Seizures and Major (Grand Mal) Seizures

Minor (Petit Mal) Seizures

Myoclonus

Summary

11—The Relationship between Drain and Mind

Perception

Memory

Entry Portal for Memory

Long-Term Storage of Memory

Emotion

Response

Prepositional Thought

Dementia

Focal Cerebral Symptoms

The Influence of the Mind on the Body

General Conclusions

Summary

Index

Details

No. of pages:
258
Language:
English
Copyright:
© Butterworth-Heinemann 1970
Published:
Imprint:
Butterworth-Heinemann
eBook ISBN:
9781483163161

About the Author

James W. Lance