Neurology

Neurologists and physicians writing on KevinMD about the brain: dementia and Alzheimer's disease and the biomarkers that now find it early, stroke and what recovery really allows, autism, Parkinson's disease, gait and balance as vital signs, and caring for a spouse or parent with a neurological illness. Three maintained records draw on this archive: Aging and dementia: what physicians say, in their own words, Heart disease: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.

MKSAP: 35-year-old woman with fever and headache

mksap

Conditions and Diseases

August 31, 2013

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 35-year-old woman is evaluated for a 1-day history of fever, headache, myalgia, arthralgia, and neck stiffness. The patient is sexually active. She had a similar episode 2 years ago, at which time results of cerebrospinal fluid (CSF) analysis showed lymphocytic meningitis. All culture results were negative, and her symptoms resolved over the next …

The gratitude of a terrified parent when kindness is shown

Pat Mastors

Patient

August 5, 2013

Hospital transport arrives to take my daughter just after 9am. We’d been told her ultrasound and x-ray were scheduled for 10am, an hour away. Jess and I exchange a look. She’s just about to take another swig of the laxative drink she’s been drinking since 8:30.

“I’ll go with you,” I say.

“We’ll make sure there’s a bathroom nearby.”

Strike one for the Golden Cocoon.

We get to the ultrasound department, and are left …

It’s time primary care doctors diagnose autism

Denise A. Somsak, MD

Conditions and Diseases

August 1, 2013

I remember how my son’s autism diagnosis was delivered. He was three years old. It wasn’t a surprise really, merely a confirmation of something that I expected and feared. He was already enrolled in speech and occupational therapy making very little progress. He saw a developmental specialist at age two and two and half who initially believed that he was not autistic but merely delayed with sensory issues. After we …

Losing my temporarily able-bodied status

Sandra L. Shea, PhD

Conditions and Diseases

August 1, 2013

I thought of Peter when I lost my TAB status.

I lost it on vacation. These things happen. Suddenly, one Friday night in Florida, I was no longer a TAB. Shouldn’t have been too surprised, I guess.

But I didn’t expect it would involve a chicken.

I should explain.

I’m a medical educator: I have a PhD in experimental psychology/neuroscience, and I teach first-year medical students. In our curriculum, the students work through patient …

Haunted by an autism diagnosis: A sense of closure after 20 years

Lisa Shulman, MD

Conditions and Diseases

July 27, 2013

I believe most physicians have cases that haunt them, often patients whose treatment courses do not go ideally and who leave a mark on the physician, altering the way he or she practices ever after. When the physician is a surgeon, it might be a patient who died on the table. For a hematologist, it might be a patient with cancer who could not be cured. For a developmental pediatrician, …

Youth sports should never knowingly risk brain damage

Claire McCarthy, MD

Conditions and Diseases

July 9, 2013

Repeated bumps to the head are bad for children. This sounds incredibly obvious, yet as a society, we don’t particularly act like we get it at all.

When the Bruins made it into the Stanley Cup finals, I thought about all the young hockey players who would be inspired to practice harder and play harder in the hope of one day doing the same. And I wondered: if they bumped their …

Every doctor can learn from a medical coder

Jessica Jou

Medical Education

June 23, 2013

Mrs. B was washing dishes in the kitchen when she heard a thump where her twelve-month-old son was asleep. She ran to him and found her son had fallen from a chair (code: e884.2). He was crying (code: 780.92) and visibly shaken, but did not have overt signs of bleeding, bruising, or trauma. She picked him up and immediately brought him to the emergency room.

There, he was triaged by the …

MKSAP: A 56-year-old woman with a severe generalized headache

mksap

Conditions and Diseases

June 22, 2013

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 56-year-old woman is evaluated in the emergency department for sudden onset of a severe generalized headache that began 36 hours ago and has not responded to over-the-counter medications. The patient has a history of hypertension treated with lifestyle modifications. She has a 30-pack-year smoking history.

On physical examination, blood pressure is 148/68 mm Hg, …

A hospital transfer may not always be a good thing

Colin Son, MD

Physician

June 20, 2013

Injury to the brain continues to be a unique thing in medicine. These injuries are scary and unfamiliar to many health care providers. There is a finality to them. Their consequences are hidden a little bit; the asystole is easy to figure in the emergency room but the suppression and brain death isn’t something so easily recognized.

They’re what you might imagine, along with polytrauma, as poster child conditions for tertiarization …

Recognizing the signs and symptoms of stroke in children

Veronica Szalkowski-Lehane, MD

Conditions and Diseases

June 9, 2013

When we think of strokes, we imagine older adults. Yet, one out of every 2,800 newborns (under 1-month) suffers a stroke. In children up to 18, it occurs in 11 out of 100,000. I know how serious this can be – my daughter experienced a stroke before birth. The day before she was born, we discovered she had hydrocephalus (water on the brain). When she was a day old, an …

Migraine is very much a childhood disorder

Roy Benaroch, MD

Conditions and Diseases

May 29, 2013

“My wife gets migraines—really bad ones—and now my daughter seems to be getting them too. She’s only 7! Is she just copying what her mom does? Can a child really start getting migraines?”

Oh, yes they can. Migraine is very much a childhood disorder. About 5% of adults have migraines, and half of them started having their migraines as kids.

As in adults, migraines in children can be severe and debilitating. However, …

What is the excuse for not taking action on Alzheimer’s?

Alexander Halperin, DDS

Conditions and Diseases

May 24, 2013

Having early-stage Alzheimer’s, I get extraordinarily sentimental when I hear the words of songs when I go for early morning walks with my headphones on.

Yesterday morning, I heard the song, “Memories,” and some of the lyrics hit my heart, soul and mind. I looked up the lyrics on the Web: “Daylight (and the sun was about to rise soon after at that time), I must wait for the sunrise, I …

How to know if your toddler has autism

Naline Lai, MD and Julie Kardos, MD

Conditions and Diseases

May 11, 2013

About half of all children in the United States with an autistic spectrum disorder are diagnosed at age five or older, according to a May 2012 NCHS (National Center for Health Statistics) data brief. However, many parents are suspicious much sooner. As part of autism awareness month, we bring you clues into toddler development that can alert you to a potential issue.

Pediatricians often use a questionnaire called the M-CHAT (Modified …

Read more…

How to know if your toddler has autism

When should drivers retire from driving?

Juliet K. Mavromatis, MD

Conditions and Diseases

May 3, 2013

When should drivers retire from driving? This question is always difficult to answer. In our suburban car culture driving allows seniors to maintain their independence and prevents social isolation. However, at what point does it become unsafe for the elderly to drive and what are the risks?

One month ago my fit and about 80-year-old in-laws were involved in a serious car accident. A young …

What medical professionalism means to me as a patient

Lisa Miller

Patient

May 2, 2013

As an employee of the ABIM Foundation, I’ve batted around the phrase “medical professionalism” for several years but it didn’t really hit home for me until I encountered it – and the lack thereof – as a patient.

Over the past six months, I’ve logged a few miles in the frequent patient program. I underwent a 13-hour craniotomy to resect a meningioma and woke up from surgery with nerve damage to …

Consider the quality of our caring, not just the quality of our care

Shanna K. Patterson, MD

Physician

April 22, 2013

I have kept some of my books from medical school displayed on the shelf, including suggested contemplative readings meant to tenderly inculcate students with a sense of compassion.

Like so many fledglings, we soar off into our chosen paths. Many new realities and considerations take hold. I shall refer to these as the “business, logistics and politics” of medicine. How can we ensure that we are adhering to the standards of …

MKSAP: 19-year-old woman with bilateral leg weakness

mksap

Conditions and Diseases

April 13, 2013

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 19-year-old woman is admitted to the hospital because of a 2-week history of bilateral leg weakness and numbness accompanied by urinary incontinence that began after a viral gastrointestinal illness of 3 days’ duration. She has no personal or family medical history of note and takes no medication.

On physical examination, temperature is 36.7 °C …

How a doctor’s online reputation survived a front page newspaper story

Kevin Pho, MD

KevinMD

April 5, 2013

The Boston Globe recently had a front page story on how a neurosurgeon sued a patient’s husband for a blog critical of the physician.

According to the story, the patient underwent a complicated back operation as a result of her bone cancer. She tragically had a stroke post-operatively, and that’s where the situation between the family and doctor deteriorated. On the advice of his psychiatrist, the patient’s husband wrote a …

Should Medicare cover PET scans for the diagnosis of dementia?

Leslie Kernisan, MD, MPH

Conditions and Diseases

March 27, 2013

Do they need a PET scan to confirm the presence or absence of amyloid plaque?

More importantly, would doing such PET scans make meaningful impacts on patients’ health?

Those are the questions that a Medicare expert panel recently considered, and their impression, after carefully reviewing lots of high-quality research, is that we don’t yet have evidence supporting the benefit of using the PET scans. Unsurprisingly, some experts disagree, including a working group …

The fine line between compassion and detachment

Christine A. Garcia, MD, MPH

Physician

March 7, 2013

I’m told every doctor has their list of unsolved patient mysteries. Those patients where something terribly awful or something miraculous happens for which you lay awake at night trying to understand. The nature of doctors is to want solve problems and figure out medical mysteries in sleuth-like Sherlock Holmes fashion. It’s these unsolved mysteries that you remember as they perplex you for days, weeks, possibly years after.

For me, it happened …

Neurology

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts