Neurology
Neurology is the branch of medicine, the science of the causes, mechanism, the diagnosis
and the treatment of the nervous system diseases. Neurology is based on neuroanatomy,
neurophysiology, neurochemistry, neuropathology and genetics. The curriculum of the
medical studies in neurology provides the opportunity to gain both theoretical and practical
skills: the neurological examination, diagnosis and the treatment of the most common
diseases of the nervous system and life-threatening cases.
The realisation of the curriculum of neurology is one of the conditions essential to obtain the
medical doctor certificate and is the basis of opening a specialisation in neurology.
Teachers
Dr n.med Beata Kukulska-Pawluczuk
Dr n.med Magdalena Nowaczewska
Lek. med. Wiktoria Rajczyk
Dr n.med Piotr Rajewski
Lek. med Adam Wiśniewski
Syllabus
I. Department of Neurology
II. Head of the unit: dr hab. n. med. Barbara Książkiewicz, prof. UMK
III. Faculty of Medicine, 5th year, 80 hours
IV. Form of the classes: seminars 40h, classes 40h
V. Form of crediting - exam
VI. Principles course objective: credit, 5 p. ECTS
VII. Topics of the course (detailed plan):
1. Physical examination, anamnesis, examination of the head and cranial nerves – examination
technique and results interpretation.
2. Motor and coordinating system
- Examination of upper and lower limbs - examination technique and results interpretation .
- Defect of the motor system: spastic and flaccid syndrome.
- Location of the injury and the size as well as character of the paresis.
- General motility of the body within the scope of physiology and pathology.
- Examination of the motor coordination - examination technique and results interpretation.
- Role of the coordinating system.
- Injury of the coordinating system and its reasons.
- Parkinson disease and other disease of extrapyramidal system
3. Syndrome of increased intracranial pressure and consciousness disorders.
- Syndrome of increased intracranial pressure and mechanism regulating the intracranial
pressure.
- Symptoms reflecting the syndrome of increased intracranial pressure and symptoms of
cerebral shift.
- Treating the syndrome of increased intracranial pressure.
- Qualitative and quantitative consciousness disorders. Primary and secondary cerebral
comas. Determining the degree of consciousness disorders.
- Life threatening symptoms. Evaluation of circulatory system, respiratory system and renal
disorders.
- General examination. Neurological examination: character and location of the injury within
the central nervous system.
4.
Syndromes revealing injury of the spinal cord and caudal equine.
- Syndrome of hemilateral and transverse core interval.
- Extra-spinal and intra-spinal syndrome.
- Conus medullaris and caudal equine syndrome.
- Posterior-cordal syndrome.
5.
Peripheral nervous syndrome.
- Plexuses: brachial, lumbosacral.
- Scope of innervation and symptoms of medial nerve, ulnar nerve, radial nerve, femoral
nerve, sciatic nerve, common peroneal and tibial nerve damage.
6.
Meningeal syndrome.
- Symptoms of meningeal syndrome, mechanism underlying the above.
- Technique used to examine meningeal symptoms.
- cerebrospinal fluis examination – technique and results
7.
Intracranial and spinal canal tumours.
- Intracranial tumours: definition of intracranial tumour, division of tumours, general
symptoms related with intracranial tumours, focal symptoms of intracranial tumours,
histopathological forms.
- Clinical symptoms and histopathological forms of spinal canal tumours.
- Diagnostic tests, treatment.
8. Epilepsy, other paroxysmal conditions.
- Epilepsy: classification of epilepsy, reasons of epilepsy, morphology of epileptic attacks.
- Differentiating epilepsy from other conditions related with losing consciousness, EEG in
epilepsy.
- Status epilepticus
- Treating epilepsy.
9. Cerebral stroke.
- Definition of stroke, epidemiology, risk factors
- Causes of ischemic and hemorrhagic strokes, subarachnoid haemorrhages.
- Pathophysiology and pathomorphology of strokes.
- Clinical symptoms concerning ischaemic strokes, hemorrhagic strokes and subarachnoid
haemorrhages, additional tests, treatment.
10. Neuroinfections.
- Clinical symptoms of meningitis and encephalitis.
- Diagnostics and clinical differentiation of inflammation with viral, bacterial and tubercular
aetiology.
- Guillain-Barre syndrome.
- Treatment of neuroinfections.
11. Spinal disorders. Neurological rehabilitation.
- Sciatica syndrome, irritation and loss sciatica, high and low sciatica.
- Etiology and clinical symptoms of sciatica and shoulder pain.
- Sciatica of disc aetiology – clinical symptoms, location, differentiation.
- Examining the patient with sciatica: subjective and objective symptoms.
- Additional tests in patients with sciatica: radiological examinations, examination of the
cerebrospinal fluid.
12. Multiple sclerosis, syringomyelia, sclerotic lateral atrophy.
- Aetiology, clinical symptoms, diagnosis, treatment.
13. Headaches as an interdisciplinary problem.
- Division of headaches.
- Reasons and pathomechanisms of headaches.
- Migraine, cluster headache, tension-type headache – aetiology, pathogenesis and
treatment.
- Neuralgia within the head with particular consideration of V nerve.
14. Dementia and disorders within higher activities of the nervous system.
- Dementia: definition, aetiology, clinical symptoms, treatment.
- Aphasia: definition, division, diagnostics.
- Disorders related with other higher functions of the CNS.
- Dysarthria.
15. Head injury
- Commotio cerebri - concussion, cerebral contusion, extradural and subdural hematoma
- Clinical symptoms , diagnostics and treatment.
VII. Literature
1. Main book –
Neurology and Neurosurgery Illustrated 5e
Kenneth W. Lindsay
Churchill Livingstone
01/10/2010
2. Additional book – neurological examination
Neurological Examination Made Easy
Geraint Fuller
Churchill Livingstone
01/05/2008
3.Complementary book
Netter's Neurology
H.Royden Jones
W.B. Saunders Company
01/10/2011
Rules and regulations
The student has to be present on seminars and exercises in order to pass.
During exercises assistant shall verify student’s preparation to classes on a regular basis by means of
oral questions, whereas during the practical the student shall be obliged to show his skills to perform
neurological examination. It is also required to write a medical history.
The practical and theoretical (test) examination shall verify the effects of students’ learning efforts.
The practical part of the test shall take part during the last block of the exercises.
The assisting physician, a specialist in neurology shall indicate a patient for each student, and the
student has to examine the patient, indicate deviations concerning the examination, propose local,
etiologic, syndrome diagnosis, as well as differentiation and recommended treatment.
The student elaborates medical history that is to be approved by the assistant.
The assistant evaluates the ability to perform neurological examination, proper naming of
abnormalities observed during the examination, accuracy of the initial diagnosis, perception
concerning differentiation with other ailments of the nervous system.
The theoretical part has a form of a test – 100 questions
The first 45 questions are statements with 5 possible answers – the student has to indicate the most
appropriate answer (a test of choice – 1 proper answer).
The following 45 questions are statements with 4 possible answers – the student selects the answers
he considers right (multiple choice test).
The last 10 questions contain description of cases basing on which the student determines the most
probable reason of the described ailment (a test of choice – 1 proper answer).