Showing 1-20 of 78 for: Essential Evidence Topics > Neurologic 
- Acoustic neuroma (vestibular schwannoma)
Essential Evidence Topics, 30-Mar-2022
Overall Bottom Line: Vestibular schwannoma (acoustic neuroma) is an important consideration in a patient presenting with asymmetric sensorineural hearing loss. Use auditory brainstem response (ABR) audiometry for the initial evaluation; however, if the
- Amyotrophic lateral sclerosis
Essential Evidence Topics, 19-Jul-2022
Overall Bottom Line: Suspect amyotrophic lateral sclerosis (ALS) in patients with weakness, fasciculations, dysarthria, or dysphagia. Diagnosis depends on finding upper motor neuron signs (such as weakness, spasticity, hyperreflexia, and Babinski signs)
- Aneurysm (cerebral)
Essential Evidence Topics, 21-Jun-2019
Overall Bottom Line: Screen for cerebral aneurysm with MRA if 2 first-degree relatives have an intracranial aneurysm and in patients with autosomal dominant polycystic kidney disease. A cerebral aneurysm of 7 mm or less has a 5-year risk of rupture of l
- Autism
Essential Evidence Topics, 26-Dec-2021
Overall Bottom Line: AAP guidelines (but not USPSTF) recommend screening all children at 18 and 24 months of age by using the M-CHAT tool. Refer children suspected of having an autism spectrum disorder (ASD) for both educational intervention services (s
- Bell's palsy
Essential Evidence Topics, 17-May-2021
Overall Bottom Line: Bell's palsy is a clinical diagnosis based on the onset of acute unilateral facial paralysis over 1 to 7 days that does not usually require further work-up. Early use (within 3 days of symptom onset) of corticosteroids increases the
- Brachial plexus injury
Essential Evidence Topics, 30-Jan-2022
Overall Bottom Line: Obstetric training in management of shoulder dystocia may prevent bracheal plexus injury at birth. Evaluate for brachial plexus injury in all cases of shoulder dystocia. Congenital plexopathy may spontaneously resolve within month
- Brain abscess
Essential Evidence Topics, 20-Oct-2021
Overall Bottom Line: Suspect brain abscess in patients with risk factors who have any combination of headache, fever, seizure, or focal neurologic deficits. Gadolinium-enhanced MRI is the preferred initial test if readily available. About two-thirds o
- Brain tumor (benign)
Essential Evidence Topics, 1-Nov-2022
Overall Bottom Line: Benign brain tumors can present as an incidental finding, or with a wide range of neurologic and endocrine symptoms related to the tumor histology, size, and location. Surgery is generally the primary treatment, but radiation therap
- Brain tumor (malignant)
Essential Evidence Topics, 11-Nov-2022
Overall Bottom Line: Obtain neuroimaging on patients with suspicious findings on neurological examination, altered mental status that is otherwise unexplained, or with symptoms or signs of increased neurological pressure. The extent of extracranial dise
- Carpal tunnel syndrome
Essential Evidence Topics, 22-Sep-2021
Overall Bottom Line: Carpal tunnel syndrome (CTS) remains a clinical diagnosis, with electromyelogram as the best confirmatory test. Symptoms that correlate best with an abnormal electromyelogram include hypalgesia, abnormal hand diagram results, and we
- Cavernous sinus thrombosis
Essential Evidence Topics, 25-Apr-2022
Overall Bottom Line: Suspect cavernous sinus thrombosis in a patient with acute onset of unilateral periorbital swelling, headache, photophobia, chemosis, proptosis, ptosis, and cranial nerve palsies progressing to bilateral involvement (especially within
- Cerebrovascular disease (acute stroke)
Essential Evidence Topics, 24-Mar-2023
Overall Bottom Line: Obtain time of symptom onset. Complete your evaluation and determine treatment within 60 minutes of the patient’s arrival in the emergency department. Obtain CT of the brain before initiating any specific treatment. Thrombolytic t
- Cerebrovascular disease (chronic management)
Essential Evidence Topics, 10-Feb-2023
Overall Bottom Line: The identification and treatment of hypertension is a cornerstone of the prevention and management of cerebrovascular disease (CVD). For the diagnosis of CVD, combined MRA and carotid duplex ultrasound is accurate and less invasive
- Charcot-Marie-Tooth syndrome
Essential Evidence Topics, 29-Jun-2021
Overall Bottom Line: Suspect Charcot-Marie-Tooth (CMT) in a patient with distal extremity muscle wasting, weakness, and a history of similarly affected family members. Consider EMG, nerve ultrasound, or biopsy and genetic testing when the diagnosis is i
- Chronic fatigue syndrome
Essential Evidence Topics, 24-Mar-2023
Overall Bottom Line: Among patients with longstanding fatigue, only about one-third meet the Centers for Disease Control and Prevention (CDC) criteria for chronic fatigue syndrome (CFS). Cognitive behavioral therapy (CBT) and graded exercise therapy
- Concussion in athletes
Essential Evidence Topics, 19-Jul-2022
Overall Bottom Line: Concussion includes a spectrum of manifestations that can range from transient mild symptoms to ongoing disabling problems. Players with previous concussion are more likely to have recurrent concussion. Women and athletes with thr
- Creutzfeldt-Jakob disease
Essential Evidence Topics, 31-Dec-2021
Overall Bottom Line: Maintain a high clinical suspicion for Creutzfeldt-Jakob disease (CJD) in patients who have rapidly progressive dementia with ataxia, new vision or sensory complaints, and/or psychiatric symptoms. Diagnostic tests that can be perfor
- Cryptococcal infection
Essential Evidence Topics, 11-Nov-2022
Overall Bottom Line: Suspect Cryptococcus infection in any person with HIV or immunocompromise with meningitis. Cryptococcus can also cause disseminated disease, and isolated pneumonia. Obtain India ink stains, fungal CSF and blood cultures, cytology,
- Delirium and acute confusional states
Essential Evidence Topics, 12-Apr-2023
Overall Bottom Line: Delirium occurs in at-risk individuals with environmental stressors as precipitants. The risk of developing delirium can be predicted using a clinical decision rule. One-third of delirium cases can be prevented by reducing risk fac
- Dementia (Alzheimer’s disease)
Essential Evidence Topics, 11-Oct-2022
Overall Bottom Line: A combination of appropriate history from a reliable informant and cognitive testing is most valuable for determining the need to work up the patient for Alzheimer’s disease (AD). Consider neuroimaging with MRI, CT, or PET scan. Vit
