Q 2.35. Neurological Emergencies and Their Management

  1. Introduction:

    • Neurological emergencies require prompt recognition and intervention to prevent further damage.
    • As a medical student, understanding basic principles of evaluation and management is crucial, even if you encounter these emergencies infrequently.
  2. Preclinical Years Inside the Classroom:

    • Neuroanatomy Foundation:
      • Build a solid understanding of neuroanatomy. Knowing pathways and system functions simplifies learning about neurological disorders.
      • Focus on localizing lesions based on clinical history and physical exams.
      • Practice self-quizzing on pathways until it becomes second nature.
    • Clinical Vignettes:
      • Exposure to patient cases aids in remembering pathophysiology, diagnosis, and treatment.
      • Hearing about real patients reinforces theoretical knowledge.
    • Board Preparation:
      • Allocate extra study time for board exams.
      • High-yield board review materials help focus on essential content.
  3. Neurological Emergencies:

    • These situations appear abruptly and often have a volatile course.
    • Early and aggressive approaches are recommended for management.
    • Common neurological emergencies include:
      • Altered Conscious Level: Immediate assessment and prompt management are crucial to prevent further damage.
      • Seizures: Rapid intervention to stop ongoing seizures.
      • Stroke: Rapid evaluation for thrombolysis or endovascular therapy.
      • Meningitis/Encephalitis: Early antibiotics or antivirals.
      • Increased Intracranial Pressure: Swift measures to reduce pressure.
      • Status Epilepticus: Urgent seizure control.
      • Neuromuscular Respiratory Failure: Ventilatory support.
      • Spinal Cord Compression: Immediate decompression.
      • Neuroleptic Malignant Syndrome: Discontinue offending drugs.
      • Myasthenic Crisis: Respiratory support and immunotherapy.
      • Guillain-Barré Syndrome: Plasmapheresis or immunoglobulins.
      • Neurovascular Emergencies: Aneurysm rupture, arteriovenous malformation, etc.
      • Neuro-Oncological Emergencies: Seizures, raised intracranial pressure, etc.

Remember, your neurology clerkship provides valuable exposure to these emergencies. Stay curious, learn actively, and apply your knowledge compassionately! 


1 aan.com

2 academic.oup.com

3 books.google.com

4 link.springer.com

5 library.med.utah.edu

Verified by Dr. Petya Stefanova