Modules

• Year 1
  • Introduction to Year 1 and Year Outcomes
  • Fundamentals of Medicine
  • Cardiorespiratory 1
  • Metabolism 1
  • Locomotor 1
  • Brain and Behaviour 1
  • Human Development 1
  • Medicine in Society 1
  • Clinical Communication Skills
  • Student Selected Component (SSC)
• Year 2
  • Introduction to Year 2 and Year Outcomes
  • Cardiorespiratory 2
  • Metabolism 2
  • Brain and Behaviour 2
  • Human Development 2
  • Human Sciences and Public Health 2
  • Locomotor 2
  • Cancer Week
  • Moving and Handling Training
  • Year 2 Lifesaver Programme
  • Clinical Communication Skills
  • Medicine in Society 2
  • Extended Patient Contact
  • Student Selected Component (SSC)
• Year 3
  • Introduction to Year 3 and Year Outcomes
  • Clinical Science and Professionalism (Weeks 1-3)
  • Cardiovascular, Respiratory and Haematology (CR3)
  • Gastroenterology and Cancer (MET3A)
  • Public Health
  • Endocrinology and Renal Medicine (MET3B)
  • General Practice and Community Care
  • Student Selected Component (SSC)
  • Clinical and Communication Skills
• Year 4
  • Introduction and Year 4 Outcomes
  • Obstetrics and Gynaecology
  • Child Health
  • HIV & Sexual Health
  • Musculoskeletal
  • Health Care of the Elderly
  • Neuroscience
  • Dermatology
  • General Practice and Community Care
  • Psychiatry
  • Ear, Nose and Throat
  • Global Health and Ethics
  • Ophthalmology
  • Clinical & Communication Skills
  • Student Selected Component (SSC)
• Year 5
  • Introduction to Year 5 and Year Outcomes
  • Teaching Week 1
  • Teaching Week 2
  • Anaesthesia & ITU (AN & ITU)
  • Breaking Bad News
  • Clinical Pharmacology & Therapeutics
  • Community Care
  • Doctors as Teachers and Educators (DATE)
  • Emergency Medicine (EMERG MED)
  • General (Internal) Medicine (G(I)M)
  • Immediate Life Support (ILS)
  • Student Assistantship
  • Simulation
  • Surgery
  • Student Selected Component (SSC)
• Year GEP 1
  • Cancer Week
  • Movement and Posture
  • Carriage of Oxygen
  • Human Sciences and Public Health
  • Digestion, Growth and Metabolism
  • Infection and Immunity
  • Ethics
  • Brain and Behaviour
  • Human Development
  • Clinical Communication Skills
  • Medicine in Society (GEP)

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Year 4 NEURO4: Neuroscience

• Mr John Brecknell
• john.brecknell@bhrhospitals.nhs.uk

Teaching Material for this Module

Introduction

The neurology course aims to build on the pre-clinical and clinical science, and clinical skills, taught within the brain and behaviour modules of the first and second years, to equip students with knowledge regarding common neurological and neurosurgical conditions and the ability to perform a neurological examination.  The level of competence should be equivalent to that of a newly qualified FY1 doctor.  The course should also provide enough exposure to the specialties of neurology and neurosurgery to inform students about career choice.  During the neurology course, students will gain an appreciation of the breadth of medical and surgical neurological pathology.  However the emphasis of the course is on those common conditions which they are likely to encounter in foundation practice as well as those unifying principles of clinical neurological assessment which underlie the specialties of neurology and neurosurgery.

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Index

• General Outcomes for Community Care
• General Outcomes for Neurosciences
• Cerebrovascular Disease (Stroke and TIA)
• Delirium and Dementia (see Psychiatry)
• Stupor, Coma and the Unconscious patient
• Head Injury
• Seizure Disorders
• De-Myelinating Diseases
• Migraine and Headaches
• Parkinson's Disease and Neuro-degenerative Disorders
• Neuromuscular disorders
• Dizzyness and Vertigo
• Tumours
• CNS Infections
• Neuropathies
• Chronic Pain
• Neurogenetic Disorders
• The patient with back pain

• General Outcomes for Community Care
  • Medical knowledge: CLINICAL FEATURES of DISEASE (TD 8 b)
    • General Outcomes for Neurological Disorders
      1. Able to describe how neurological disease presents within the community
  • Clinical skills: MAKING A DIAGNOSIS and CLINICAL JUDGEMENT (TD 14 e-f)
    • General Outcomes for Neurological Diagnosis
      1. Describe the presentation, examination and management of patients with headaches in primary care
  • Clinical skills: FORMULATING A TREATMENT PLAN (TD 14 g)
    • Management of Neurological Disorders
      1. Awareness of chronic neurological diseases in the community recognising how these patients are managed in the community
      2. Describe the presentation, examination and management of patients with headaches in primary care
  • Professional issues: WORKING IN TEAMS (TD 22 a-c)
    • Multi-disciplinary Team Work (MDT)
      1. Understand the role of allied health professionals in the care of chronic neurological diseases
• General Outcomes for Neurosciences
  • TD 16: PROVIDE IMMEDIATE CARE IN MEDICAL EMERGENCIES
    • Intermediate & Advanced Life Support
      1. Describe the resuscitation and immediate management of patients suffering from neuromuscular respiratory failure
  • Medical knowledge: ANATOMY (TD 8.1)
    • Vision
      1. Describe the functional neuro-anatomy underlying the following neurological deficits a) Visual fields – homonymous hemianopia, bi-temporal hemianopia; b) Pupils – relative afferent pupillary defect; c) Eye movements – oculomotor, trochlear and abducens palsies, internuclear ophthalmoplegia; d) Facial expression – forehead sparing, upper motor neuron facial palsy; e) Bulbar palsy – dysphonia, dysphagia, aspiration; f) Patterns of motor loss – monoparesis, hemiparesis, quadraparesis, paraparesis, differences between upper and lower motor neuron weakness; g) Patterns of sensory loss – peripheral neuropathy, hemi-anaesthesia, sensory level, Brown-Séquard Syndrome; h) Cauda equina syndrome.
    • Cranial Nerves
      1. Describe the functional neuro-anatomy underlying the following neurological deficits a) Visual fields – homonymous hemianopia, bi-temporal hemianopia; b) Pupils – relative afferent pupillary defect; c) Eye movements – oculomotor, trochlear and abducens palsies, internuclear ophthalmoplegia; d) Facial expression – forehead sparing, upper motor neuron facial palsy; e) Bulbar palsy – dysphonia, dysphagia, aspiration; f) Patterns of motor loss – monoparesis, hemiparesis, quadraparesis, paraparesis, differences between upper and lower motor neuron weakness; g) Patterns of sensory loss – peripheral neuropathy, hemi-anaesthesia, sensory level, Brown-Séquard Syndrome; h) Cauda equina syndrome.
  • Medical knowledge: PATHOLOGY (TD 8.7)
    • Hydrocephalus
      1. Describe the pathology, presentation, investigation and management of hydrocephalus
  • Clinical skills: INTERPRETING FINDINGS AND INITIAL ASSESSMENT (TD 14 a-b)
    • Interpreting findings and initial assessment
      1. Interpret historical and examination findings in order to begin to formulate a differential diagnosis, suggest reasonable investigations and produce a management plan including pharmacological therapy where appropriate
  • Medical knowledge: CLINICAL FEATURES of DISEASE (TD 8 b)
    • Hydrocephalus
      1. Describe the pathology, presentation, investigation and management of hydrocephalus
  • Clinical skills: HISTORY (TD 13 a-b)
    • Taking a History
      1. Take, record and present a neurological history, including a drug history
  • Clinical skills: PHYSICAL EXAMINATION (TD 13 c)
    • Examining the Patient
      1. Perform an examination of the cranial nerves and the neurology of the upper and lower limbs
  • Clinical skills: PLANNING AND INTERPRETING INVESTIGATIONS (TD 14 c-d)
    • Neurological Imaging
      1. Demonstrate an ability to distinguish between CT, T1 & T2 weighted images and recognise gross abnormalities
    • Neurological Investigations
      1. Describe the role of clinical neurophysiology in the investigation of neurological disease
      2. Interpret historical and examination findings in order to begin to formulate a differential diagnosis, suggest reasonable investigations and produce a management plan including pharmacological therapy where appropriate
  • Clinical skills: MAKING A DIAGNOSIS and CLINICAL JUDGEMENT (TD 14 e-f)
    • General Outcomes for Neurological Diagnosis
      1. Interpret historical and examination findings in order to begin to formulate a differential diagnosis, suggest reasonable investigations and produce a management plan including pharmacological therapy where appropriate
  • Clinical skills: FORMULATING A TREATMENT PLAN (TD 14 g)
    • Management of Neurological Disorders
      1. Interpret historical and examination findings in order to begin to formulate a differential diagnosis, suggest reasonable investigations and produce a management plan including pharmacological therapy where appropriate
  • Clinical skills: INTERACTION WITH PATIENTS (TD 15 a-b)
    • Interacting with Patients - General
      1. Present historical and examination findings to a medical practitioner
  • Clinical skills: PRESCRIBING DRUGS SAFELY AND EFFECTIVELY (TD 17 a-h)
    • Pharmacological Therapy - Neurological Disorders (General)
      1. Take, record and present a neurological history, including a drug history
      2. Interpret historical and examination findings in order to begin to formulate a differential diagnosis, suggest reasonable investigations and produce a management plan including pharmacological therapy where appropriate
• Cerebrovascular Disease (Stroke and TIA)
  • Cerebrovascular Accident (CVA / Stroke)
    1. Describe the pathology, presentation, investigation and management of stroke
• Delirium and Dementia (see Psychiatry)
  • General Outcomes for Delirium and Dementia
    1. Describe the pathology, presentation, investigation and management of dementia
• Stupor, Coma and the Unconscious patient
  • General
    1. Describe the functional neuro-anatomy underlying coma
    2. Perform and present an examination of the conscious level
    3. Describe the resuscitation and immediate management of patients suffering from coma
• Head Injury
  • General Outcomes for Head Injury
    1. Describe the pathology, presentation, investigation and management of head injury
    2. Describe the resuscitation and immediate management of patients suffering from injury to the head
• Seizure Disorders
  • Epilepsy (General)
    1. Describe the pathology, presentation, investigation and management of epilepsy
    2. Demonstrate knowledge of therapeutics, pharmacokinetics, side effects and interactions for Carbamezapine, Phenytoin & Valproate
    3. Describe the resuscitation and immediate management of patients suffering from status epilepticus
• De-Myelinating Diseases
  • Multiple sclerosis
    1. Describe the pathology, presentation, investigation and management of multiple sclerosis
    2. Interpret the presence of oligoclonal bands in CSF
• Migraine and Headaches
  • Acute headache
    1. Describe the pathology, presentation, investigation and management of subarachnoid haemorrhage
    2. Interpret the following features of CSF – cell count & xanthochromia
  • General
    1. Describe the pathology, presentation, investigation and management of headache
• Parkinson's Disease and Neuro-degenerative Disorders
  • Parkinson's Disease
    1. Describe the pathology, presentation, investigation and management of parkinson's disease
    2. Demonstrate knowledge of therapeutics, pharmacokinetics, side effects and interactions for carbidopa / levodopa
  • Motor Neurone disease
    1. Describe the pathology, presentation, investigation and management of motor neuron disease
• Neuromuscular disorders
  • Myasthenia Gravis
    1. Describe the pathology, presentation, investigation and management of myasthenia gravis
• Dizzyness and Vertigo
  • General
    1. Interpret the history and examination in order to begin to formulate a differential diagnosis for a patient complaining of dizziness, suggest reasonable investigations and produce a management plan including pharmacological therapy where appropriate.
• Tumours
  • General Outcomes for Tumours
    1. Describe the pathology, presentation, investigation and management of brain tumours
• CNS Infections
  • Meningitis
    1. Describe the pathology, presentation, investigation and management of infective meningitis
    2. Interpret the following features of CSF – cell count, protein content, glucose content
    3. Describe the resuscitation and immediate management of patients suffering from meningitis
• Neuropathies
  • General
    1. Able to describe how neurological disease presents within the community
    2. Awareness of chronic neurological diseases in the community recognising how these patients are managed in the community
    3. Describe the pathology, presentation, investigation and management of peripheral neuropathy
    4. Describe the presentation, examination and management of patients with headaches in primary care
• Chronic Pain
  • General
    1. Describe the pathology, presentation, investigation and management of spondylosis
    2. Describe the resuscitation and immediate management of patients suffering from injury to the spine
• Neurogenetic Disorders
  • General
    1. Demonstrate an awareness of the fundamental mechanisms of genetic disorder, drawing on neurological examples
• The patient with back pain
  • Spondylosis, spondylolisthesis and spondylolysis
    1. Describe the pathology, presentation, investigation and management of spondylosis
    2. Describe the resuscitation and immediate management of patients suffering from injury to the spine

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