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MEDICAL / Neurology
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Acute heat illnesses
Suspect always heatstroke when physical activity is accompanied by hot skin, altered consciousnes...
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Acute porphyria
Acute intermittent porphyria, porphyria variegata, and to a lesser degree hereditary coproporphyr...
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ADHD
ADHD (attention deficit hyperactivity disorder) is a common neuropsychiatric disorder that has at...
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Amyotrophic lateral sclerosis (ALS)
The terms ALS and motor neurone disease (MND) are often used interchangeably. ALS is the most com...
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An unconscious patient
An unconscious patient cannot communicate, is unarousable and does not obey commands. Unconscious...
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Aphasia
Aphasia is a disorder affecting the processing, formulation and comprehension of spoken and writt...
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Assessment of physical and cognitive functioning
Many different measures are used in the assessment of physical, cognitive and psychological funct...
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Ataxia
Ataxia is defined as an inability to coordinate movements. Ataxia produces, for example, balance ...
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Benign paroxysmal positional vertigo (BPPV)
Benign paroxysmal positional vertigo (BPPV) is the most common vertigo inducing vestibular disord...
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Brain and spinal cord tumours
A tumour is found in about one fifth of adult patients who present with newly diagnosed epilepsy ...
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Brain contusion
Brain contusion can be suspectedif a patient with brain injury is unconscious for several minutes...
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Brain death
The death of a person refers to the permanent cessation of all integrated brain function. Brain d...
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Cerebral infarction (ischaemic stroke)
The treatment of cerebral infarction has been intensified during the recent years. Most patients ...
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Chronic pain
The principal treatment responsibility of pain patients lies with the primary health care. Specia...
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Clinical assessment of memory impairment
If a progressive memory disease is suspected (e.g. one of the domains in the CERAD test battery i...
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Clinical neurophysiology in diagnostics
Clinical neurophysiology is a branch of medicine concerned with the measurement of the electrical...
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Clinical use of neuroradiological imaging
Always consider, whether the possible benefit from the investigation is greater than the harm to ...
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Curable causes of memory-related symptoms and diseases
Identify curable causes of memory-related symptoms and diseases. Treat these patients before thei...
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Delirium in the elderly
Delirium or acute confusional state is an extensive, rapid-onset disturbance of brain function du...
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Depression, drugs and somatic diseases
Depression is a common disorder related to other psychiatric and somatic diseases, and it often c...
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Detection of neurological disorders in children
Refer all children with developmental stagnation for further investigations without delay. Tre...
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Diabetic neuropathy
The diagnosis of diabetic neuropathy is based on the diagnosis of diabetes, typical symptoms and ...
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Differential diagnostics of episodic symptoms
The majority of episodic symptoms are benign, but the possibility of potentially serious conditio...
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Diseases of the spinal cord
The first thing to assess is whether symptoms originating from the spinal cord are caused by a tr...
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Encephalitis
Encephalitis should be suspected in patients with acute-onset headache, confusion, fever or cloud...
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Encephalitis in children
All children with suspected encephalitis should be investigated and treated in a hospital. Signs ...
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Epilepsy in children
Early diagnosis of childhood epilepsy is important and often improves prognosis. Epilepsy startin...
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Examining a patient after an epileptic seizure
The first physician attending to the patient should establish and record the course of the seizur...
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Eyelid myokymia
Benign, self-limited muscle contractions usually involving the orbicularis oculi muscle Not assoc...
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Falls of the elderly
In 10% of cases, falls of the elderly lead to serious injuries, e.g. hip fractures. Reduce alread...
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Fatigue
Fatigue may be associated with many chronic diseases. Diseases possibly causing fatigue should be...
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Frontotemporal lobar degeneration
Frontotemporal lobar degeneration is a progressive memory disease with three typical symptom pict...
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Gait disturbances
In a young or working-aged person gait disturbance is most often caused by a specific disease. In...
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Guidelines regarding sudden unexpected death in infancy
Sudden infant death syndrome (SIDS) may be prevented by instructing parents not to let the infant...
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Guillain-Barré syndrome (polyradiculitis)
Polyneuritis is an inflammation of the nerve roots. It affects mainly the motor nerves and has an...
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Headache
Headache is experienced by 70–95% of all people at some point in their life.Thorough patien...
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Headache in children
Sporadic headaches are common and do not require further investigations or treatment. Headache ma...
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Hiccup
Hiccup is a myoclonus of the diaphragm in which the diaphragmatic muscle is suddenly contracted. ...
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Hydrocephalus and shunt complications
Approximately 500 ml of cerebrospinal fluid (CSF) is formed within the brain each day, principall...
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Hyperventilation
Recognize and treat non-psychogenic causes of hyperventilation. In elderly persons, psychogenic c...
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Increased intracranial pressure
The possibility of increased intracranial pressure must be considered in a patient whose symptoms...
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Insomnia
There is usually no single cause of insomnia but, in addition to medical causes, there are a numb...
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Intracerebral haemorrhage
Intracerebral haemorrhage is the cause of ca. 15% of strokes. Hypertension is the most common cau...
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Intracranial aneurysm and subarachnoid haemorrhage (SAH)
Subarachnoid haemorrhage (SAH) should be suspected however slight the symptoms, and the diagnosis...
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Intracranial haematomas
Suspect an intracranial haematoma when a patient with a head injury has progressive headache, con...
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Involuntary movements
Involuntary movements (dyskinesias) are often caused by an injury or disorder in the extrapyramid...
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Learning disorders
Learning disorders include difficulties in reading and writing, disturbances in arithmetic skills...
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Listeriosis
Pregnant women, persons with immunodeficiency and elderly persons with multiple diseases must avo...
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Lumbar puncture, examination of cerebrospinal fluid and findings
A general practitioner usually has to perform a lumbar puncture only in an emergency setting.
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Meningitis
Bacterial meningitis should always be suspected in a patient with headache, high fever and neck s...
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Meningitis in children
Suspect bacterial meningitis if a child is clearly ill and has severe symptoms. Acute bacterial m...
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Mental disorders due to somatic disease
Somatic diseases that cause psychiatric symptoms particularly in the early phase should be identi...
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Meralgia paraesthetica
Entrapment of the lateral femoral cutaneous nerve in the inguinal area Seen especially in middle-...
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Migraine
The therapy for mild migraine consists of paracetamol, aspirin or NSAIDs either alone or combined...
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Mild traumatic brain injury (concussion)
Mild traumatic brain injury has to be recognized, the condition of the patient assessed and an ap...
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Multiple sclerosis (MS)
Multiple sclerosis (MS) is an autoimmune disease of unknown aetiology that affects the white matt...
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Muscle weakness and paralysis symptom
The underlying causes of muscle weakness or a paralysis symptom may include disorders of the uppe...
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Myasthenia gravis and myasthenic syndrome
Myasthenia gravis is arare autoimmune disease, in which the function of the myoneural junction of...
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Narcolepsy and other hypersomnias of central origin
These conditions are very rare causes of excessive sleepiness but should nevertheless be identifi...
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Nausea and vomiting
The most common cause of acute nausea is an acute gastroenteritis. The patient usually has concur...
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Nerve entrapment and compression disorders
Compression neuropathy, i.e. peripheral nerve compression, is caused by external pressure on the ...
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Neuroleptic malignant syndrome (NMS)
The possibility of neuroleptic malignant syndrome should be kept in mind in patients on antipsych...
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Neurological disorders and alcohol
It is recommended that as a general precaution all patients with a known history of chronic alcoh...
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Neurological examination
Obtaining the patient's history is the most important part of a neurological examination, pro...
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Neurological eye symptoms
An impression of the site of a neuro-ophthalmic lesion and its possible cause may be obtained by ...
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Neuropsychological disorders
Damage or injury to the brain may cause temporary or permanent changes in the patient's cogni...
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Obstructive sleep apnoea in the adult
Sleep-related breathing disorders reduce the quality of sleep and cause daytime fatigue.Untreated...
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Parkinson's disease
The motor symptoms of the disease are caused by destruction of the neurones of the nigrostriatal ...
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Peripheral facial paralysis
Peripheral facial paralysis is often idiopathic (known as Bell’s palsy) but it may also be ...
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Peripheral neuropathies: examination of the patient
Determine the level of the disorder: is there a damage to the peripheral nerve system (e.g. disor...
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Pituitary tumours
The majority of pituitary tumours are benign adenomas.The tumours may be hormonally active and be...
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Poliomyelitis and post-polio syndrome
Poliomyelitis (polio) is a highly contagious disease, but in the majority of cases it causes no s...
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Polymyalgia rheumatica
Among the vast amount of patients who suffer from pain those should be identified in whom the sym...
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Polyneuropathies
Symmetrical disease of (motor and sensory) peripheral nerves and/or the autonomic nerve system Th...
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Radiculopathies
Pain radiating from the spine to the territory innervated by the affected root is the most typica...
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Rehabilitation of the stroke patient
The best results are obtained by starting rehabilitation early . Extensive long-term therapy is a...
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Restless legs and akathisia
Restless legs syndrome is a condition in which the patient experiences nocturnal, unpleasant sens...
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Sequelae of traumatic brain injury
Traumatic brain injury (also called a ”head injury”) must include trauma to the head ...
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Shunt complications in children
The signs of shunt malfunction are similar to the signs of hydrocephalus: the signs of s...
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Skull and brain injury
Recognize possible acute injury to the brain. Evaluate the severity of the brain injury according...
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Speech and language development
Children deviating from the age-related development path should be referred to a speech therapist...
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Spinal cord injuries
Consider the possibility of spinal cord injury in all trauma patients, and ensure that transport ...
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Suspicion of rabies
Rabies is a fatal disease, but it is always preventable through a series of vaccinations and immu...
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Symptoms of arrhythmia and examination of an arrhythmia patient
Patient's medical history, clinical examination and resting ECG are the cornerstones for diag...
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Syncope: causes and investigations
Identify benign causes of disturbed consciousness in order to avoid unnecessary extensive investi...
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Systemic diseases in pregnancy
Poorly treated or untreated systemic disease impairs fertility; adequate management effectively r...
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Temporal (giant cell) arteritis
Remember the possibility of temporal arteritis as a cause of headache, visual disturbances and di...
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Tinnitus
Establish the aetiology. In some cases, the cause may be eliminated (noise, otosclerosis, acousti...
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Transient global amnesia (TGA)
Transient global amnesia (TGA) refers to a benign episode of memory loss of unknown aetiology, wh...
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Treating psychological problems in persons with intellectual disability (ID) in primary health care
The essential goals are to recognize conditions requiring a more specific assessment of a possibl...
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Treatment of a prolonged epileptic seizure and status epilepticus
A prolonged seizure with unconsciousness is a life-threatening emergency situation requiring imme...
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Treatment of epilepsy in adults
Epilepsy requires regular, long-term pharmacotherapy, and the indications should be considered ca...
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Treatment of spasticity
Spasticity does not necessarily require treatment. It may function as support for a limb with wea...
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Tremor
The most important diseases with tremor are essential tremor and Parkinson's disease . Variou...
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Trigeminal neuralgia and other facial pain
Trigeminal neuralgia is characterized by paroxysms of intense pain resembling electrical shocks o...
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Vascular cognitive impairment and dementia
The average disease duration is about 5 years; the prognosis of the disease is worse than in Alzh...
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Vasculitides
Vasculitis has to be taken into account when the patient presents with systemic symptoms
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Vertigo
Benign postural vertigo, cervical vertigo, orthostatic hypotension and vestibular neuronitis shou...
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Winged scapula (scapula alata)
Injury to the accessory nerve in association with a surgical intervention should be readily recog...
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