By Frank W. Drislane MD, Dr. Juan Acosta, Louis Caplan MD, Dr. Bernard Chang MD MMSc, Andrew Tarulli
Blueprints Neurology presents scholars with a whole overview of the most important issues and concepts—perfect for clerkship rotations and the USMLE. This version has been thoroughly updated—including new diagnostic and remedy info throughout—while keeping its succinct, prepared, and concise type. a hundred board-format questions and solutions with entire right and fallacious solution factors look on the finish of the book.
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These areas have a direct connection with the contralateral PPRF and participate in saccadic movements. Other areas that contribute to saccadic control include the dorsolateral prefrontal cortex, supplementary eye field, and parietal lobe. Vertical saccades may also originate in frontal eye fields or superior colliculi and connect to the contralateral riMLF. Inability to produce saccades is called oculomotor apraxia. Abnormal saccades include those that overshoot (hypermetric) or undershoot (hypometric) and unwanted saccades or saccadic intrusions (square wave jerks, ocular flutter, and opsoclonus).
In the cavernous sinus, they run with the inferior division of the third nerve and ultimately synapse in the ciliary ganglion. The iris contains two muscles that regulate pupil size. The sphincter is a pupilloconstrictor innervated by parasympathetic fibers of the third nerve. The dilator (pupillodilator) is innervated by the cervical sympathetic system. qxd 10/4/08 3:17 PM Page 32 32 • Blueprints Neurology TABLE 4-1 Comparison of Visual Loss According to Localization Lesion Level Causes Symptoms/Signs Visual Field Defect Eye Usually refractive error; central retinal artery occlusion; retinal detachment; central retinal vein occlusion RAPD present; usually unilateral; vision improves with pinhole Depends on the cause; only one eye affected Optic nerve Usually inflammatory lesions (MS and sarcoid); ischemic (vasculitis, atherosclerosis), such as AION; infiltrative (neoplasia) Monocular visual loss; ipsilateral RAPD; discs swelling Central, centrocecal, arcuate, or wedge field defect in the affected eye Chiasm Parasellar mass, including pituitary adenoma, craniopharyngioma, meningioma, aneurysm, etc.
Generalized arrhythmic slow activity often indicates a diffuse encephalopathy. Interictal epileptiform findings include sharpand spike-wave discharges, with or without an accompanying slow wave. Electrographic seizures may take various forms. The most common are rhythmic spike- or sharp- and slow-wave discharges or rhythmic slow waves. They may be focal or generalized. Activation procedures can be used to enhance the likelihood of finding abnormal EEG patterns: hyperventilation is useful for provoking EEG changes in patients with absence seizures, while photic stimulation can induce EEG changes in patients with myoclonic seizures.