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Domain – Neurological presentations (guiding topics)
- Take an appropriate neurological history and perform a neurological examination relevant to the patient and the presentation.
- Recognise, assess and manage a child with:
- cerebral palsy
- spina bifida
- autism spectrum disorder
- attention deficit hyperactivity disorder
- delay or regression in developmental milestones
- brain tumour
- febrile convulsions
- epilepsy.
- Diagnose and manage the following presentations:
- acute, subacute or episodic changes in mental status or level of consciousness
- gradual cognitive decline
- aphasia
- headache or facial pain
- back of neck pain
- blurry vision or diplopia
- dizziness or vertigo
- dysarthria or dysphagia
- weakness – focal or generalised
- involuntary movements
- numbness, paraesthesia and neuropathic pain
- urinary or faecal incontinence/retention
- unsteadiness, gait disturbance or falls
- sleep problems including insomnia and sleepwalking
- hearing loss
- Diagnose and manage the following emergency presentations:
- acute stroke (ischaemic or haemorrhagic) or transient ischaemic attack (TIA)
- acute visual loss
- central nervous system infection, including encephalitis, meningitis, cerebral abscess and epidural abscess
- encephalopathy
- Guillain-Barré syndrome
- head trauma
- increased intracranial pressure
- status epilepticus
- subarachnoid haemorrhage
- cauda equina syndrome
- delirium
- Ramsay Hunt syndrome.
- Diagnose and manage common neurological disorders:
- Alzheimer’s disease
- multi-infarct dementia
- Bell’s palsy
- carpal tunnel syndrome
- epilepsy
- essential tremor
- headache (tension, migraine, cluster, medication overuse)
- Parkinson’s disease
- peripheral neuropathy (motor, sensory and autonomic)
- benign intracranial hypertension
- concussion
- traumatic brain injury
- trigeminal neuralgia
- benign paroxysmal positional vertigo
- restless leg syndrome and periodic limb movement
- motion sickness.
- Diagnose and manage less common neurological disorders:
- multiple sclerosis
- myasthenia gravis
- motor neurone disease
- polyneuropathy
- myopathy (inherited or acquired)
- other types of dementia, including Lewy body dementia, frontotemporal dementia, and mixed dementia
- berry aneurysm
- Korsakoff syndrome and Wernicke encephalopathy
- Huntington’s disease
- normal pressure hydrocephalus
- Arnold Chiari malformation
- brain tumours, benign and malignant
- hypersomnolence and narcolepsy
- other intracranial bleeding (extradural and subdural haemorrhage).
- Counsel, and appropriately refer for genetic testing and counselling, the patient with a neurological illness with a genetic component, or with a family history of a neurological illness with a genetic component. This includes, but is not limited to, Huntington’s disease, frontotemporal dementia, and certain brain tumours/cancer syndromes.
- Understand the medico-legal considerations for neurological presentations/disorders, such as fitness to drive or ability to fulfil a job role safely.
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