Department of Neurology

Neurology Clerkship
4th Year Student

Goals and Objectives of the Clinical Neurology Clerkship

Goals: To learn the principles and skills underlying the recognition and management of neurologic diseases that a general practitioner is most likely to encounter in practice, with special emphasis on the neurologic emergencies.

Objectives:

Content of subjects to be taught:

  1. The neurologic examination (as an integral component of the general medical examination):
    1. how to perform a complete neurologic examination
    2. how to perform a screening neurologic examination
    3. how to recognize and interpret abnormal findings on the neurologic examination

  2. Localization – general principles differentiating lesions at the following levels:
    1. cerebral hemisphere
    2. posterior fossa
    3. spinal cord
    4. nerve root/plexus
    5. peripheral nerve (mononeuropathy, polyneuropathy, and mononeuropathy multiplex)
    6. neuromuscular junction
    7. muscle

  3. Disease Management – general principles governing (urgent and non-urgent) evaluation and management of:
    1. acute mental status changes
    2. strokes
    3. seizures
    4. chronic mental status changes
    5. headaches and facial pain
    6. low back pain
    7. peripheral neuropathies (especially subacute toxic and metabolic neuropathies and Guillain-Barre syndrome)
    8. cranial neuropathies (notably Bell’s palsy, third nerve palsy)
    9. common movement disorders (notably Parkinson disease, essential tremor, tardive dyskinesia)
    10. meningitis and encephalitis
    11. multiple sclerosis
    12. myasthenia gravis
    13. polymyositis
    14. primary and metastatic CNS tumors
    15. sleep disorders (notably obstructive sleep apnea, narcolepsy)
    16. developmental delay and developmental regression

  4. Identify the following normal anatomy on a CT or MR scan:
    1. frontal, parietal, temporal and occipital lobes
    2. sylvian fissure
    3. caudate and putamen
    4. globus pallidus
    5. substantia nigra
    6. thalamus
    7. pituitary gland
    8. cerebellum and cerebellar peduncles
    9. midbrain, pons and medulla
    10. lateral, third and fourth ventricles and the cerebral aqueduct
    11. corpus callosum
    12. spinal cord
    13. intervertebral disc and nerve root
    14. cauda equina

  5. Identify the following types of pathology on a CT scan or MR scan:
    1. subarachnoid hemorrhage
    2. intracerebral hematoma
    3. brain abscess
    4. infarct (hemorrhagic vs bland)
    5. glioma, meningioma and metastatic brain tumor
    6. subdural and epidural hemorrhage
    7. Arnold-Chiari malformation
    8. hydrocephalus
    9. multiple sclerosis
    10. herniated intervertebral disk
    11. cerebral edema

  6. Identify the following normal anatomy on a conventional cerebral angiogram or MR angiogram:
    1. common, internal and external carotid arteries
    2. vertebral and basilar arteries
    3. anterior, middle and posterior cerebral arteries

  7. Using angiography, recognize
    1. atherosclerotic stenosis and occlusion of a major vessel
    2. arteriovenous malformation
    3. cerebral aneurysm