Objectives

1. Students will elicit a detailed neurologic history.
2. Students will perform the neurologic examination, including mental status, cranial nerves, motor system, coordination, gait, reflexes, and sensation.
3. Students will administer the Mini-Mental State Examination (MMSE).
4. Students will be familiar with basic findings disclosed by the funduscopic examination.
5. Students will compare and contrast the key findings of brain injury (i.e., confusion, delirium, amnesia, concussion, stupor, coma, minimally conscious state, and vegetative state), and develop an appropriate management plan.
6. For patients with cerebrovascular disease, students will create (1) an evaluation plan that includes history, neurologic exam, neuroimaging, and other appropriate tests, and (2) a management plan that includes anticoagulation, antiplatelet therapy, tissue plasminogen activator, surgical therapy, and rehabilitation.
7. Students will compare and contrast the major syndromes relevant to dementia (i.e., amnesia, mild cognitive impairment, Alzheimer’s Disease, vascular dementia, and depression), and develop an appropriate management plan.
8. For patients with multiple sclerosis, students will create (1) an evaluation plan that includes history, neurologic examination, magnetic resonance imaging, and cerebrospinal fluid analysis, and (2) a management plan that includes corticosteroids, immunotherapy, symptomatic treatments, and rehabilitation.
9. For patients with seizure disorders, students will create (1) an evaluation plan that includes history, neurologic examination, electroencephalography, and neuroimaging, and (2) a management plan that includes anticonvulsant drugs and surgical therapy.
10. Students will compare and contrast the major syndromes relevant to altered mental status (i.e., acute confusional state, delirium, dementia, aphasia, apraxia, agnosia, neglect, frontal lobe syndromes, depression, mania, and psychosis), and develop an appropriate management plan.
11. For patients with dizziness and vertigo, students will apply the appropriate basic science concepts of the cardiovascular and vestibular systems to the evaluation and care of affected patients.
12. Students will compare and contrast the major diagnoses relevant to headache, (i.e., common migraine, classic migraine, tension headache, temporal arteritis, and subarachnoid hemorrhage), and develop an appropriate management plan.
13. For patients with weakness and numbness (including corticospinal dysfunction, movement disorders such as Parkinson’s Disease, cerebellar disorders, spinal cord disease, motor neuron disease, peripheral neuropathy, neuromuscular junction disease, and myopathy), students will create (1) an evaluation plan that includes history, neurologic exam, and appropriate tests, and (2) a management plan that includes medications, surgery, and rehabilitation.
14. Students will apply the appropriate basic science concepts that include the neuroanatomy and neuropathology of the eye and visual system to the care of patients with visual dysfunction.
15. Students will understand the medical, legal, and ethical implications of brain death, the vegetative state, and the minimally conscious state.
16. Students will understand the indications for and limitations of computed tomography (CT), magnetic resonance imaging (MRI), electroencephalography (EEG), and nerve conduction studies and electromyography (NCS/EMG).
17. Students will have performed or witnessed a lumbar puncture (LP), and will understand the indications for LP and the interpretation of basic cerebrospinal fluid findings.
18. Students will demonstrate effective communication of medical information with patients.
19. Students will demonstrate effective communication with colleagues, consultants, and other professionals.
20. Students will demonstrate effective patient advocacy.
21. Students will demonstrate good communication and listening skills with patients and families.
22. Students will demonstrate patient-centered communication and collaborative decision making.
23. Students will demonstrate the ability to communicate with technology.
24. Students will elicit values, ideas, and feelings influencing the patient/physician relationship and treatment decisions.
25. Students will be proficient at preparing initial history and neurologic examination write-ups and SOAP notes for patients.
26. Students will be comfortable with the oral presentation of a history and neurologic examination to colleagues and attendings.

Competencies

1. Confusion – e.g. delirium, acute confusional state, toxic-metabolic encephalopathy, coma, stupor
2. Amnesia – e.g. memory loss, forgetfulness, anoxia, concussion, traumatic brain injury
3. Cerebrovascular Disease – e.g. stroke, ischemic, hemorrhagic, or lacunar infarct; intracerebral hemorrhage
4. Dementia – e.g. Alzheimer’s Disease, vascular dementia, subdural hematoma, brain tumor
5. Dizziness – e.g. vertigo, benign positional vertigo, orthostatic hypotension
6. Migraine – e.g. common migraine, classic migraine, combined headache
7. Multiple Sclerosis – e.g. MS, demyelinative disease, optic neuritis, neuromyelitis optica, ADEM
8. Epilepsy – e.g. partial seizures, generalized seizures, status epilepticus, psychogenic seizures
9. Numbness – e.g. neuropathy, peripheral neuropathy, mononeuropathy, root compression syndrome
10. Weakness – e.g. hemiparesis, monoparesis, paraparesis, motor neuron disease, myopathy