Neurology |
Neurology |
| Neurology - |
| Neurology Magazine directed to physicians concerned with diseases and conditions of the nervous system |
| AAN American Academy of Neurology |
| Neuro Training in Science - Common test exam questions and answers about neuro sciences. |
| When are most neurons produced? / Prenatally |
| Are there more neurons produced than needed? / Yes |
| How much does the brain weigh at birth? / 350g |
| What is the number one cause of death during the first year of life? / Birth defects |
| What are the three major stages of development and when do they happen? / 1. Zygotic: 0-14 days 2. Embryotic: 14 days to 8 weeks 3. Fetal: 8 weeks to 36 weeks |
| When does a majority of myelination occur? / Postnatally |
| What are the five stages of NeuroDevelopment ? / 1. Neurulation 2. Proliferation 3. Migration 4. Differentiation 5. Synaptogenesis |
| What is the neural tube the precursor for? / the neurons and glial cells of the CNS. |
| What is the PNS the made from? / Neural crest cells |
| What day in development does the blastocyst form? / Day 5 |
| What part of the blastula becomes the embryo proper? / the ICM |
| What does the placenta form from? / Trophoectoderm |
| What day does the ICM delaminate? / Day 5 |
| What part of the ICM becomes the embryo proper? / the epiblast |
| What part of the ICM becomes the yolk sack? / the hypoblast |
| What is the aggregation medially where the cells dive down in the epiblast? / Primitive streak or groove |
| What end of the epiblast does the primitive groove begin at? / the cranial end (Hensen's node) |
| What is the notochord derived from? / Axial mesoderm |
| What is the importance of the notochord in regard to NeuroDevelopment ? / It induces the formation of the neural plate from the ectoderm. |
| What day does the neural plate form? / Day 18-19 |
| Which end of the neural plate is wider and what will it give rise to? / the cranial end is wider and it will give rise to the brain. |
| What does the caudal portion of the neural plate give rise to? / Spinal cord |
| During primary neurulation, how does cell morphology change? / Cells take on a more pseudostratified character. |
| What is the area in the middle of the folding during neurulation called? What is it between? When does it form? / 1. Neural groove 2. Neural folds 3. 18-19 |
| When does closure of the neural tube occur? What area of the tube closes first? / 1. Week 4 2. the midline |
| Where is the primary hinge joint in neurulation? / the midline |
| During wedging, how does a cell change its shape? / It widens at the basolateral end while narrowing at the apical end. |
| Where do secondary hinge joints occur in neurulation? / Dorsolaterally |
| At what level does the neural tube start fusing? / the level of the 4th somite |
| Which neuropores fuse first, last? / 1. Rostral 2. Caudal |
| What are the two phases of neurulation in higher vertabrates? What is developed in each stage? = 1. Primary - Brain 2. Secondary -formation of caudal structures |
| What causes the phenomenon of segmentation? / the change in cell to cell adhesion properties. Most likely tight junctions. |
| First segmentation produces what three vesicles? / 1. Prosencephalon 2. Mesencephalon 3. Rhombocephalon |
| What causes the actual differentiation in segement size? How is this achieved? / Different pressures of CSF cause by transient blockages. |
| Where does the cephalic flexure occur? / Between the prosencephalon and the mesencephalon. |
| Where does the cervical flexure occur? / Between the hindbrain and the spinal cord |
| What does the prosencephalon divide into? = The telencephalon and the diencephalon. |
| What does the rhombocephalon divide into? / the metencephalon and the myencephalon. |
| The forebrain gives rise to which ventricles? / 1 2 and 3 |
| The midbrain gives rise to which part of the ventricular system? / the cerebral aqueduct |
| The hindbrain gives rise to which ventricle? / the 4th ventricle |
| Dorsal alar plates have what function and what are they separated by? / Sensory functions and the roof plate |
| The ventral basilar plates have what function and what are they separated by? / Motor function and the floor plate |
| What is the furrow between the basilar and alar plates called? / the sulcus limitans |
| What neurons in the PNS are not of neural crest origin(3)? / 1. Cranial sensory neurons 2. Motor neurons which have their cell bodies in the CNS 3. Preganglionic autonomic neurons |
| What is the name given to cells that lie just outside the neural plate? / Placodal ectoderm cells |
| Cranial neural crest cells are from what level up and what are some of the things that they give rise to? / 5th somite and up; skeletal elements of the branchial arches and periocular structures |
| Truncal neural crest cells are from what level down? / the 6th somite down. |
| What are neural crest cells highly prone to? / Mutations and tumors. |
| What is the most common neurological defect seen at birth? / Neural tube defects |
| What is a result of the caudal neuropore (5) not closing upon birth? / Spina bifida |
| What is the most common neural tube defect? / Spina bifida |
| What condition is usually associated with spina bifida? / Hydrocephalus |
| Including what in your diet can cut down on the occurance of spina bifida? / Folic acid |
| What defect is seen as a result of anterior neuropore (2) closure? / Anencephaly |
| What defect is described as having part of the brain protruding through the skull? / Encephalocele |
| What is a failure of the lobes of the brain to separate? / Holoprosencephaly |
| What often is seen with holoprosencephaly? / Malfortmation of the midline structures of the face. |
| What are the four types of induction? / 1. Binary choice 2. Graded response 3. Relayed signals 4. Reciprocal signaling |
| Inductive signals that allow the ectoderm to differentiate into neuroectoderm originate where? / Notochord |
| What portion of the blastopore is the neural inducing region? / the dorsal lip of the blastopore |
| What chemicals are produced by the neural inducing region to promote neuroectoderm formation / 1. Noggin 2. Chordin 3. Follistatin |
| How do the chemicals that induce neuroectoderm formation actually do that? / They antagonize BMP which is an inhibitor of neuroectoderm formation. |
| What family do BMPs belong to? / TGF- B |
| What is the default pathway? / Formation of neuronal tissue. |
| What type of cell adhesion proteins do neural plate ectoderm cells express? / N- Cadherins and N- Cam |
| How is the dorsal-ventral axis established? What chemical is associated which each direction of the axis? / the dorsal epidermis produces of gradient of BMP for dorsal differentiation. the notochord produces a gradient of Shh for ventral differentiation. |
| What mutation is specifically associated with holoprosencephaly? / Shh |
| What transcription factor downstream of Shh is also been linked to defects? / Glee |
| What set of trascription factors (large group) can also lead to defects? / Homeobox (Hox) domain TF |
| What signaling molecules (4) are involved in the production of the anterior/posterior axis? / 1. Wnt 2. BMP 3. Retinoic acid 4. FGF |
| When does proliferation of cells with in the neural tube begin? End? / 5 weeks; 7th month postnatally |
| Most neurons are produced between what days prenatally? / 42 and 120 |
| Which form first, neurons or glial cells? / Neurons |
| At the peak level of mitosis, what is the rate of formation of neurons? / 250,000 neurons/minute |
| Where are the cortical neurons produced? / the ventricular zone of the neural tube. |
| What are the two intervals of proliferation and what are their purposes? / 1. Pre- Neurogenic: proliferation of the cells 2. Neurogenic: cells leave and go take their place in the cortex |
| Where do cells form their cell to cell adhesions and undergo synaptogenesis after proliferation? / Just below the cortical plate |
| Why do the cells that are proliferating look like they are pseudostratified? / They are at different stages of the cell cycle. |
| What are the two different types of cleavage seen during cell proliferation? / 1. Symmetrical 28-42 2. Asymmetrical |
| When do migrating cells arrive at their final destination? / Five months |
| What cells make the pathway for migrating neurons? / Radial glial cells |
| How would you describe the manner in which the cortex develops? / Inside-out manner ie the oldest cortex is the deepest |
| What is it called when cells migrate to a particular level and then move tangentially? / Tangential migration |
| Where can you find neural stem cells in adult life(2)? / Hippocampus and the sub-ventricular region of the cortex |
| What is the best studied molecule of migration? / Reelin |
| What two other knock-outs have shown a result of maldevelopment of the cortex? / Apoprotein-E and VLDL receptor |
| What is an example of a LDL receptor that has been shown to cause defects close to holoprosencephaly in knockout models? / Megalin |
| When does differentiation and synaptogenesis begin? End? / 4 or 5 months; 6th month postnatally |
| What are the two types of cues that cause differentiation? / Intrinsic and extrinsic |
| What exactly does the differentiation process involve? / the activation of specific genes for a specific cell type. |
| What molecules allow synaptogenesis? / Neurotransmitters, Cell adhesion molecules and neurotrophic factors (BNDF) |
| What is apoptosis? What percent of cells undergo apoptosis? / A subtractive process; 20-50% |
| What is responsible for the 3x of brain mass? / Increase in the density of synapes and myelination. |
| Neurodevelopment - Course Introduction to Neurology. Neuro Development, Ectoderm, Neural Crest Cells, Neuro Developmental Milestones, Gross Motor, Cognition Cognitive |
| AMA ASSN - Archives of Neurology from the American Medical Association |
| Neurology is a branch of medicine. For the scientific study of the nervous system and related with Neurosciences or
Neurological Sciences.
System : Nervous system Significant diseases : Neuropathy, dementia, stroke, encephalopathy, Parkinson's disease, epilepsy, meningitis, muscular dystrophy, migraine, attention deficit/hyperactivity disorder Significant tests : Computed axial tomography, MRI scan, lumbar puncture, electroencephalography Specialist : Neurologist Glossary : Glossary of medicine |
| Neurology (from Greek: νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is the branch of medicine dealing with the diagnosis and treatment of all categories of conditions and disease involving the brain, the spinal cord and the peripheral nerves.
Neurological practice relies heavily on the field of neuroscience, the scientific study of the nervous system. |
| A neurologist is a physician specializing in neurology and trained to investigate, diagnose and treat neurological disorders.
Neurologists treat a myriad of neurologic conditions, including stroke, seizures, movement disorders such as Parkinson's disease, autoimmune neurologic disorders such as multiple sclerosis, headache disorders like migraine and dementias such as Alzheimer's disease. Neurologists may also be involved in clinical research, clinical trials, and basic or translational research. While neurology is a nonsurgical specialty, its corresponding surgical specialty is neurosurgery. |
| History of neurology. The academic discipline began between the 15th and 16th centuries with the work and research of many neurologists such as Thomas Willis, Robert Whytt, Matthew Baillie, Charles Bell, Moritz Heinrich Romberg, Duchenne de Boulogne, William A. Hammond, Jean-Martin Charcot, C. Miller Fisher and John Hughlings Jackson. Neo-Latin neurologia appeared in various texts from 1610 denoting an anatomical focus on the nerves (variably understood as vessels), and was most notably used by Willis, who preferred Greek νευρολογία.
Training Neurologist, Occupation Names Physician, Medical Practitioner Occupation type : Profession Activity sectors : Medicine Education required : M.D. or D.O. (US), M.B.B.S. (UK), D.M. (Doctorate of Medicine) (India), M.B. B.Ch. B.A.O. (Republic of Ireland) Fields of employment : Hospitals, Clinics Polish neurologist Edward Flatau greatly influenced the developing field of neurology. He published a human brain atlas in 1894 and wrote a fundamental book on migraines in 1912. Jean-Martin Charcot is considered one of the fathers of neurology. |
| Many neurologists also have additional training or interest in one area of neurology, such as stroke, epilepsy, headache, neuromuscular disorders, sleep medicine, pain management, or movement disorders. |
| In the United States and Canada, neurologists are physicians who have completed a postgraduate training period known as residency specializing in neurology after graduation from medical school. This additional training period typically lasts five years, with the first year devoted to training in internal medicine.
On average, neurologists complete a total of eight to ten years of training. This includes four years of medical school, five years of residency and an optional one to two years of fellowship. |
| While neurologists may treat general neurologic conditions, some neurologists go on to receive additional training focusing on a particular subspecialty in the field of neurology. These training programs are called fellowships, and are one to two years in duration. Subspecialties include brain injury medicine, clinical neurophysiology, epilepsy, neurodevelopmental disabilities, neuromuscular medicine, pain medicine, sleep medicine, neurocritical care, vascular neurology (stroke),
behavioral neurology, child neurology, headache, multiple sclerosis, neuroimaging, neurooncology, and neurorehabilitation. |
| In Germany, a compulsory year of psychiatry must be done to complete a residency of neurology. |
| In the United Kingdom and Ireland, neurology is a subspecialty of general (internal) medicine. After five years of medical school and two years as a Foundation Trainee, an aspiring neurologist must pass the examination for Membership of the Royal College of Physicians (or the Irish equivalent) and complete two years of core medical training before entering specialist training in neurology.
Up to the 1960s, some intending to become neurologists would also spend two years working in psychiatric units before obtaining a diploma in psychological medicine. However, that was uncommon and, now that the MRCPsych takes three years to obtain, would no longer be practical. A period of research is essential, and obtaining a higher degree aids career progression. Many found it was eased after an attachment to the Institute of Neurology at Queen Square, London. Some neurologists enter the field of rehabilitation medicine (known as physiatry in the US) to specialise in neurological rehabilitation, which may include stroke medicine, as well as traumatic brain injuries. Physical examination - Neurological examination |
| During a neurological examination, the neurologist reviews the patient's health history with special attention to the patient's neurologic complaints. The patient then takes a neurological exam. Typically, the exam tests mental status, function of the cranial nerves (including vision), strength, coordination, reflexes, sensation and gait. This information helps the neurologist determine whether the problem exists in the nervous system and the clinical localization. Localization of the pathology is the key process by which neurologists develop their differential diagnosis. Further tests may be needed to confirm a diagnosis and ultimately guide therapy and appropriate management.
Clinical tasks |
| Neurologists examine patients who are referred to them by other physicians in both the inpatient and outpatient settings. Neurologists begin their interactions with patients by taking a comprehensive medical history, and then performing a physical examination focusing on evaluating the nervous system. Components of the neurological examination include assessment of the patient's cognitive function, cranial nerves, motor strength, sensation, reflexes, coordination, and gait. |
| In some instances, neurologists may order additional diagnostic tests as part of the evaluation. Commonly employed tests in neurology include imaging studies such as computed axial tomography (CAT) scans, magnetic resonance imaging (MRI), and ultrasound of major blood vessels of the head and neck. Neurophysiologic studies, including electroencephalography (EEG), needle electromyography (EMG), nerve conduction studies (NCSs) and evoked potentials are also commonly ordered.
Neurologists frequently perform lumbar punctures to assess characteristics of a patient's cerebrospinal fluid. Advances in genetic testing have made genetic testing an important tool in the classification of inherited neuromuscular disease and diagnosis of many other neurogenetic diseases. The role of genetic influences on the development of acquired neurologic diseases is an active area of research. |
| Some of the commonly encountered conditions treated by neurologists include headaches, radiculopathy, neuropathy, stroke, dementia, seizures and epilepsy, Alzheimer's disease, attention deficit/hyperactivity disorder,
Parkinson's disease, Tourette's syndrome, multiple sclerosis, head trauma, sleep disorders, neuromuscular diseases, and various infections and tumors of the nervous system. Neurologists are also asked to evaluate unresponsive patients on life support to confirm brain death. |
| Treatment options vary depending on the neurological problem. They can include referring the patient to a physiotherapist, prescribing medications, or recommending a surgical procedure. |
| Some neurologists specialize in certain parts of the nervous system or in specific procedures. For example, clinical neurophysiologists specialize in the use of EEG and intraoperative monitoring to diagnose certain neurological disorders.
Other neurologists specialize in the use of electrodiagnostic medicine studies – needle EMG and NCSs. In the US, physicians do not typically specialize in all the aspects of clinical neurophysiology – i.e. sleep, EEG, EMG, and NCSs. The American Board of Clinical Neurophysiology certifies US physicians in general clinical neurophysiology, epilepsy, and intraoperative monitoring. The American Board of Electrodiagnostic Medicine certifies US physicians in electrodiagnostic medicine and certifies technologists in nerve-conduction studies. Sleep medicine is a subspecialty field in the US under several medical specialties including anesthesiology, internal medicine, family medicine, and neurology. Neurosurgery is a distinct specialty that involves a different training path, and emphasizes the surgical treatment of neurological disorders. |
| Also, many nonmedical doctors, those with doctoral degrees (usually PhDs) in subjects such as biology and chemistry, study and research the nervous system. Working in laboratories in universities, hospitals, and private companies, these neuroscientists perform clinical and laboratory experiments and tests to learn more about the nervous system and find cures or new treatments for diseases and disorders. |
| A great deal of overlap occurs between neuroscience and neurology. Many neurologists work in academic training hospitals, where they conduct research as neuroscientists in addition to treating patients and teaching neurology to medical students. |
| General caseload. Neurologists are responsible for the diagnosis, treatment, and management of all the conditions mentioned above. When surgical or endovascular intervention is required, the neurologist may refer the patient to a neurosurgeon or an interventional neuroradiologist. In some countries, additional legal responsibilities of a neurologist may include making a finding of brain death when it is suspected that a patient has died. Neurologists frequently care for people with hereditary (genetic) diseases when the major manifestations are neurological, as is frequently the case. Lumbar punctures are frequently performed by neurologists. Some neurologists may develop an interest in particular subfields, such as stroke, dementia, movement disorders, neurointensive care, headaches, epilepsy, sleep disorders, chronic pain management, multiple sclerosis, or neuromuscular diseases. |
| Overlapping areas. Some overlap also occurs with other specialties, varying from country to country and even within a local geographic area. Acute head trauma is most often treated by neurosurgeons, whereas sequelae of head trauma may be treated by neurologists or specialists in rehabilitation medicine. Although stroke cases have been traditionally managed by internal medicine or hospitalists, the emergence of vascular neurology and interventional neuroradiology has created a demand for stroke specialists. The establishment of Joint Commission-certified stroke centers has increased the role of neurologists in stroke care in many primary, as well as tertiary, hospitals. Some cases of nervous system infectious diseases are treated by infectious disease specialists. Most cases of headache are diagnosed and treated primarily by general practitioners, at least the less severe cases. Likewise, most cases of sciatica are treated by general practitioners, though they may be referred to neurologists or surgeons (neurosurgeons or orthopedic surgeons). Sleep disorders are also treated by pulmonologists and psychiatrists. Cerebral palsy is initially treated by pediatricians, but care may be transferred to an adult neurologist after the patient reaches a certain age. Physical medicine and rehabilitation physicians may treat patients with neuromuscular diseases with electrodiagnostic studies (needle EMG and nerve-conduction studies) and other diagnostic tools. In the United Kingdom and other countries, many of the conditions encountered by older patients such as movement disorders, including Parkinson's disease, stroke, dementia, or gait disorders, are managed predominantly by specialists in geriatric medicine. |
| Clinical neuropsychologists are often called upon to evaluate brain-behavior relationships for the purpose of assisting with differential diagnosis, planning rehabilitation strategies, documenting cognitive strengths and weaknesses, and measuring change over time (e.g., for identifying abnormal aging or tracking the progression of a dementia) |
| Relationship to clinical neurophysiology
In some countries such as the United States and Germany, neurologists may subspecialize in clinical neurophysiology, the field responsible for EEG and intraoperative monitoring, or in electrodiagnostic medicine nerve conduction studies, EMG, and evoked potentials. In other countries, this is an autonomous specialty (e.g., United Kingdom, Sweden, Spain). |
| Overlap with psychiatry
Psychoneuroimmunology and Neuropsychiatry In the past, prior to the advent of more advanced diagnostic techniques such as MRI some neurologists have considered psychiatry and neurologic to overlap. Although mental illnesses are believed by many to be neurological disorders affecting the central nervous system, traditionally they are classified separately, and treated by psychiatrists. In a 2002 review article in the American Journal of Psychiatry, Professor Joseph B. Martin, Dean of Harvard Medical School and a neurologist by training, wrote, "the separation of the two categories is arbitrary, often influenced by beliefs rather than proven scientific observations. And the fact that the brain and mind are one makes the separation artificial anyway". |
| Neurological disorders often have psychiatric manifestations, such as post-stroke depression, depression and dementia associated with Parkinson's disease, mood and cognitive dysfunctions in Alzheimer's disease, and Huntington disease, to name a few. Hence, the sharp distinction between neurology and psychiatry is not always on a biological basis. The dominance of psychoanalytic theory in the first three-quarters of the 20th century has since then been largely replaced by a focus on pharmacology.
Despite the shift to a medical model, brain science has not advanced to a point where scientists or clinicians can point to readily discernible pathological lesions or genetic abnormalities that in and of themselves serve as reliable or predictive biomarkers of a given mental disorder. |
| Neurological enhancement
The emerging field of neurological enhancement highlights the potential of therapies to improve such things as workplace efficacy, attention in school, and overall happiness in personal lives. However, this field has also given rise to questions about neuroethics and the psychopharmacology of lifestyle drugs can have negative and positive effects on neurology because different types of drugs can depend on people and their lives |
| American Board of Psychiatry and Neurology |
| American Osteopathic Board of Neurology and Psychiatry |
| Developmental Neurorehabilitation |
| List of neurologists |
| List of women neuroscientists |
| Neuroepigenetics |
| Neurohospitalist, a physician interested in inpatient neurological care |
| Books and References |
| AMA |
| ACGME Program Requirements for Graduate Medical Education in Neurology. Download PDF document. |
| AAN Patients - Working with Your Doctor. American Academy of Neurology. |
| Neurological Disorders. Johns Hopkins Department of Neurology. Conditions and diseases. |
| The etymology of neurology, redux: early use of the term by Jean Riolan the Younger. Brain. Janssen, Diederik F, 2021. |
| Mehta, Arpan R; Mehta, Puja R; Anderson, Stephen P; MacKinnon, Barbara L H; Compston, Alastair, 2021. |
| Medical Practitioners Act, 1927. Irish Statute Book |
| Medical Council (IE) |
| Jean-Martin Charcot: The Father of Neurology. Clin Med Res. Kumar DR, Aslinia F, Yale SH, Mazza JJ (2014). |
| Length of Residencies. Washington University Medical School. WUSTL |
| CMA Neurologist Profile. Education Portal. PDF Download |
| ABMS Guide to Medical Specialties (PDF). American Board of Medical Specialties. |
| Neurology in the German training system for psychiatrists – a personal view. The British Journal of Psychiatry. Thiels, Cornelia (2013). |
| How long does it take to become a neurologist in the UK?. Neurotray Tuarez, Jaimar (2020). |
| Neurological Diagnostic Tests and Procedures Fact Sheet. By the NINDS / NIH |
| Who Can Diagnose ADHD?. Additude Mag |
| ACNS American Clinical Neurophysiology Society. |
| ABCN American Board of Clinical Neurophysiology, Inc. |
| ABEM Exam. |
| ABMS Specialty and Subspecialty Certificates. |
| The integration of neurology, psychiatry, and neuroscience in the 21st century. The American Journal of Psychiatry. Martin JB (May 2002). |
| A New Intellectual Framework for Psychiatry. American Journal of Psychiatry. Kandel, Eric R. (1998). |
| Looking at things in a different perspective created the idea of ethics of neural enhancement using noninvasive brain stimulation. Neurology. Hamilton Roy (2011). |
| Neurology - General Information and References |