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Neurology
Differentiating Alzheimer's disease from vascular dementia — clinical, neuroimaging, and biomarker approach
A 74-year-old hypertensive male presents with a 2-year history of progressive cognitive decline. His deficits began abruptly after a lacunar infarct and have progressed in a stepwi…
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166d ago
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Neurology
CGRP antagonists vs traditional migraine prophylaxis (topiramate, propranolol, amitriptyline) — when to escalate?
A 35-year-old female with chronic migraine (> 15 headache days/month) has failed topiramate and amitriptyline due to side effects. She is now on overusing triptans. What is the cur…
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166d ago
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102
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Neurology
Systematic approach to peripheral neuropathy workup: axonal vs demyelinating, and key treatable causes
A 58-year-old diabetic male presents with bilateral symmetric distal numbness, burning pain, and mild weakness of foot dorsiflexion. EMG/NCS shows predominantly axonal sensorimotor…
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166d ago
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2ans
81
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Neurology
Prevention and management of cerebral vasospasm after aneurysmal subarachnoid hemorrhage
A 55-year-old woman with aneurysmal SAH (Hunt-Hess grade 3, Fisher grade 3) had successful coil embolization on day 1. On day 5, she develops new focal deficits and TCD shows eleva…
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166d ago
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117
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Neurology
When to initiate levodopa in Parkinson's disease — early vs delayed treatment debate
A 62-year-old man with newly diagnosed Parkinson's disease presents with mild resting tremor, rigidity, and bradykinesia but is still functionally independent. He asks whether star…
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166d ago
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120
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Neurology
Management of Guillain-Barré syndrome: IVIG vs plasmapheresis, and ICU monitoring criteria
A 30-year-old male presents with ascending weakness starting in the legs, areflexia, and mild respiratory compromise 2 weeks after a campylobacter gastroenteritis. NCS confirms AID…
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166d ago
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92
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Neurology
Headache red flags (SNOOP4) — which patients need urgent neuroimaging?
A 42-year-old woman presents to the ED with a sudden severe headache she describes as the worst of her life, with onset during exercise. No fever, no neck stiffness initially. How …
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166d ago
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130
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Neurology
Key differences between MS and NMOSD: clinical, imaging, and CSF findings
A 28-year-old female presents with bilateral optic neuritis and transverse myelitis extending over 3 vertebral segments. MRI spine shows a long central cord lesion at C3-C6. Serum …
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166d ago
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1ans
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Neurology
Step-by-step management of refractory status epilepticus in the ICU
A 35-year-old known epileptic presents with continuous tonic-clonic seizure activity lasting > 30 minutes unresponsive to IV lorazepam 4mg and IV levetiracetam 3g. He is now intuba…
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166d ago
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111
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Neurology
Ischemic stroke thrombolysis beyond the 4.5-hour window: who qualifies with advanced imaging?
A 67-year-old patient woke up with right-sided hemiparesis and aphasia. Time last known well is 9 hours ago. NIHSS is 12. MRI DWI shows small core infarct with large penumbra on pe…
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166d ago

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