Neurological history, examination and localisation
A step-by-step neurological examination and how to turn its findings into a lesion localisation, from mental state to gait.
Checked against sourcesVerified 31 October 2026
Neurology and special senses
Diseases of the brain, spinal cord, nerves and muscles, and of the eye and ear.
Introduction
Neurology is the study of the brain, spinal cord, nerves and muscle, with the eye and the ear. Most of the work is localisation: from the story and the examination, decide where in the nervous system the lesion lies, then choose the tests.
This section starts with examination and investigation, then stroke and brain bleeds, headache and seizures, degenerative and movement disorders, inflammatory nerve and muscle disease, tumours, and finally the eye and the ear.
Every topic uses the same layout: a short summary, what you should be able to do afterwards, the mechanism, the clinical picture, tests, treatment and the traps. Doses, thresholds and time windows are checked against named guidelines and shown with their source, because guidelines and countries sometimes differ.
How to study neurology and special senses
Learn neurology by asking two questions first: where is the lesion, and how fast did it develop? Sudden onset points to vascular causes, a days-to-weeks course to inflammation or infection, and a slow course to degeneration or tumour.
Learn the time windows and thresholds that change what you do: the stroke treatment windows, the timing of CT and lumbar puncture in thunderclap headache, the status epilepticus drug sequence and the red flags of cord compression. The check-yourself questions at the end of each topic test them a few days later.
Link neurology to other chapters: stroke and syncope meet cardiology, headache and encephalopathy meet emergency medicine, and many eye signs point to a neurological or systemic cause.
Contents by part
The topics below are in teaching order. Each part builds on the one before it.
- Examination and investigation. Localising the lesion, the neurological examination, imaging, lumbar puncture and cord syndromes.
- Stroke and bleeding in the head. Ischaemic and haemorrhagic stroke, venous thrombosis, haematomas, rehabilitation and prevention.
- Headache, seizures and dizziness. Primary and secondary headache, epilepsy and status epilepticus, vertigo and syncope.
- Degenerative and movement disorders. Dementia, Parkinson disease, Huntington disease, tremor and dystonia, motor neurone disease and prion disease.
- Alzheimer disease and the dementias: approach
- Vascular, frontotemporal and Lewy body dementia
- Normal pressure hydrocephalus
- Creutzfeldt-Jakob disease and prion disease
- Parkinson disease and parkinsonism
- Huntington disease and restless legs syndrome
- Tremor, dystonia and other movement disorders
- Amyotrophic lateral sclerosis
- Aphasias and cortical syndromes
- Inflammatory, nerve and muscle disease. Multiple sclerosis, autoimmune encephalitis, neuropathy, myasthenia, myopathy, neuropathic pain and spinal cord compression.
- Multiple sclerosis
- Autoimmune encephalitis and CNS vasculitis
- Peripheral neuropathy and Guillain-Barre syndrome
- Myasthenia gravis and Lambert-Eaton myasthenic syndrome
- Myopathy and muscle disease in adults
- Neuropathic pain and spasticity
- Spinal cord compression and myelopathy
- Wernicke-Korsakoff and metabolic encephalopathies
- Brain death
- Tumours and neurocutaneous disease. Brain, spinal and ocular tumours and the neurocutaneous syndromes.
- The eye and the ear. Visual fields and glaucoma, the red eye, cataract and macular degeneration, retinal disease and hearing loss.
Topics
Clinical neuroanatomy and spinal cord syndromes
Localise nervous system lesions and recognise classic spinal cord syndromes, UMN versus LMN signs, and the evidence-based management of tabes and ALS.Checked against sourcesVerified 1 November 2026Neuroimaging: choosing between CT, MRI and angiography
How to choose CT, MRI and angiography in neurological disease, with indications, safety, radiation, contrast and typical findings.Checked against sourcesVerified 31 October 2026Lumbar puncture and CSF interpretation
How to perform a lumbar puncture, when to image first, and how to read opening pressure and cerebrospinal fluid in meningitis, subarachnoid haemorrhage.Checked against sourcesVerified 31 October 2026Peripheral nerve injuries and high-yield peripheral nerves
Peripheral nerve injuries and entrapment neuropathies: anatomy, Seddon classes, brachial plexus and limb nerve lesions, diagnosis, and guideline-based.Checked against sourcesVerified 1 November 2026Cranial nerve palsies, Bell palsy and diplopia
Peripheral cranial nerve palsies and diplopia: third, fourth and sixth palsies, Bell palsy, Ramsay Hunt, optic neuritis, papilloedema.Checked against sourcesVerified 31 October 2026
Ischaemic stroke and transient ischaemic attack
How blocked brain arteries cause stroke or TIA, how to recognise, image and treat them fast, and how to prevent recurrence.Checked against sourcesVerified 1 November 2026Subarachnoid haemorrhage
Sudden thunderclap headache from a ruptured brain aneurysm: diagnosis by CT and lumbar puncture, urgent securing of the aneurysm, and prevention of vasospasm.Checked against sourcesVerified 1 November 2026Intracerebral haemorrhage
Non-traumatic bleeding into the brain parenchyma: causes by site, emergency imaging, blood pressure targets, reversal, surgery and prognosis.Checked against sourcesVerified 1 November 2026Intracranial haematomas and cavernous sinus thrombosis
Acute and chronic subdural and epidural haematomas after head injury, and septic or aseptic cavernous sinus thrombosis: imaging, surgery, antibiotics and.Checked against sourcesVerified 1 November 2026Cerebral venous sinus thrombosis and rarer stroke causes
How cerebral vein and sinus thrombosis and other uncommon causes lead to stroke, how they present, are diagnosed, and are treated.Checked against sourcesVerified 31 October 2026Stroke rehabilitation and secondary prevention
A clinical pathway after stroke: multidisciplinary rehabilitation, dysphagia, spasticity and mood, and secondary prevention targets for blood pressure.Checked against sourcesVerified 31 October 2026Primary headache disorders
Primary headache disorders: migraine, tension-type and cluster headache - classification, ICHD-3 criteria, treatment and complications.Checked against sourcesVerified 1 November 2026Secondary headache disorders
Secondary headache disorders: red flags, urgent causes (GCA, IIH, infection, tumour), medication overuse, and the step-by-step approach.Checked against sourcesVerified 1 November 2026Trigeminal neuralgia and cauda equina syndrome
An emergency and a first-contact pair: lancinating trigeminal pain managed with carbamazepine, and cauda equina compression demanding urgent MRI and.Checked against sourcesVerified 1 November 2026Seizures and epilepsy
Seizures and epilepsy: what they are, how they are classified and diagnosed, how they are treated, and how to live safely with them.Checked against sourcesVerified 1 November 2026Status epilepticus
A neurological emergency: prolonged or repeated seizures without recovery, with timed treatment, causes, complications and prognosis.Checked against sourcesVerified 1 November 2026Epilepsy in special situations
Assessment, treatment safety and special situations in epilepsy: first seizures, driving, withdrawal, contraception and pregnancy, SUDEP.Checked against sourcesVerified 31 October 2026Vertigo, dizziness and syncope: neurological approach
How to sort vertigo, dizziness and syncope into peripheral, central and cardiovascular causes: history, examination, red flags and treatment.Checked against sourcesVerified 1 November 2026Alzheimer disease and the dementias: approach
How to recognise, investigate, treat and support people with Alzheimer disease and other dementias, with current UK, US and biomarker criteria.Checked against sourcesVerified 1 November 2026Vascular, frontotemporal and Lewy body dementia
Vascular, frontotemporal and Lewy body dementia compared: patterns, imaging, diagnostic criteria and treatment.Checked against sourcesVerified 1 November 2026Normal pressure hydrocephalus
A reversible cause of gait, cognitive and urinary problems in older adults: ventriculomegaly without raised pressure, treated with shunt surgery.Checked against sourcesVerified 1 November 2026Creutzfeldt-Jakob disease and prion disease
A fatal prion disease: sporadic, variant, familial and iatrogenic forms; rapidly progressive dementia with myoclonus; MRI, EEG, CSF and RT-QuIC diagnosis.Checked against sourcesVerified 1 November 2026Parkinson disease and parkinsonism
Parkinson disease and parkinsonism: pathology, motor and non-motor features, differential diagnosis, treatment following NICE, MDS and AAN.Checked against sourcesVerified 1 November 2026Huntington disease and restless legs syndrome
Huntington disease: chorea and psychiatric change; restless legs syndrome: an urge to move at rest, treated with iron or gabapentinoids.Checked against sourcesVerified 1 November 2026Tremor, dystonia and other movement disorders
Tremor, dystonia and other movement disorders: essential versus Parkinson tremor, dystonia and botulinum toxin, ataxia, Wilson disease, and drug-induced.Checked against sourcesVerified 31 October 2026Amyotrophic lateral sclerosis
Progressive motor neuron disease: upper and lower motor neuron signs, diagnostic criteria, riluzole, edaravone, respiratory and nutritional care, genetics.Checked against sourcesVerified 1 November 2026Aphasias and cortical syndromes
Aphasia types and cortical syndromes (neglect, agnosia, apraxia): artery localisation, causes, assessment, imaging, and rehabilitation in stroke and brain.Checked against sourcesVerified 1 November 2026Multiple sclerosis
A chronic inflammatory demyelinating disease of the CNS: phenotypes, 2017 McDonald criteria, MRI and CSF findings, and DMT-based care.Checked against sourcesVerified 1 November 2026Autoimmune encephalitis and CNS vasculitis
Autoimmune encephalitis and primary CNS vasculitis: antibodies, Graus criteria, tumour screening, immunotherapy, ESO guidance, and low-resource care.Checked against sourcesVerified 31 October 2026Peripheral neuropathy and Guillain-Barre syndrome
Axonal and demyelinating neuropathies, common causes, nerve conduction studies, GBS criteria and treatment, and CIDPChecked against sourcesVerified 31 October 2026Myasthenia gravis and Lambert-Eaton myasthenic syndrome
Autoimmune weakness at the neuromuscular junction: myasthenia gravis and Lambert-Eaton myasthenic syndrome, from antibodies and tests to modern treatment.Checked against sourcesVerified 1 November 2026Myopathy and muscle disease in adults
How proximal weakness, creatine kinase and EMG point to muscle disease in adults, from inflammatory and statin-related myopathy to inherited dystrophies and.Checked against sourcesVerified 31 October 2026Neuropathic pain and spasticity
How nerve pain and muscle overactivity are recognised, graded and treated, from first-line drugs to botulinum toxin.Checked against sourcesVerified 31 October 2026Spinal cord compression and myelopathy
Spinal cord compression and myelopathy: malignant MSCC, degenerative cervical myelopathy, transverse myelitis, subacute combined degeneration, urgent MRI.Checked against sourcesVerified 31 October 2026Wernicke-Korsakoff and metabolic encephalopathies
How thiamine deficiency, liver, kidney, sodium and oxygen failure disturb brain function, and how to recognise and treat each.Checked against sourcesVerified 31 October 2026Brain death
Brain death pathway: preconditions, brainstem reflexes, apnoea test, ancillary tests, mimics, family communication, organ donation.Checked against sourcesVerified 1 November 2026Primary brain tumours and metastases
Primary and secondary brain tumours: gliomas, meningiomas, medulloblastomas, schwannomas, CNS lymphoma and metastases, with classification, imaging.Checked against sourcesVerified 1 November 2026Spinal tumours and metastatic spinal disease
Spinal cord and spinal column tumours: meningioma, schwannoma, ependymoma, astrocytoma, metastatic disease, presentation, MRI, steroids, surgery and.Checked against sourcesVerified 31 October 2026Ocular tumours
How ocular tumours of the eyelid, conjunctiva, uvea, retina and orbit present, are staged, and are treated.Checked against sourcesVerified 31 October 2026Neurocutaneous disorders
Neurofibromatosis 1 and 2, tuberous sclerosis complex, Sturge-Weber syndrome and von Hippel-Lindau disease: genetics, features, surveillance and treatment.Checked against sourcesVerified 1 November 2026Visual field defects and glaucoma
How the visual pathway explains field defects, and how glaucoma is recognised, measured and treated with drops, laser and surgery.Checked against sourcesVerified 1 November 2026Red eye, corneal injury and uveitis
How to sort out a red eye: causes by mechanism, red flags, exam and tests, and first steps for corneal injury, uveitis and conjunctivitis.Checked against sourcesVerified 1 November 2026Cataracts and age-related macular degeneration
Cataracts and AMD: from classification and risk factors to surgery and anti-VEGF therapy.Checked against sourcesVerified 1 November 2026Retinal vascular occlusion
Sudden, painless loss of vision in one eye from retinal artery embolism or venous thrombosis, including the CRAO emergency.Checked against sourcesVerified 1 November 2026Diabetic and hypertensive retinopathy
Retinal disease from diabetes and hypertension: grading, screening, detachment, retinitis pigmentosa, and anti-VEGF and laser treatment.Checked against sourcesVerified 31 October 2026Hearing loss, tinnitus and the vestibular system
Conductive and sensorineural hearing loss, bedside tests, sudden deafness as an emergency, age- and noise-related loss, ototoxicity, tinnitus assessment.Checked against sourcesVerified 31 October 2026