Video

A young woman with generalized myasthenia gravis.

Related to: Practical Neurology, 5e > 31: Approach to the Patient with Acute Muscle Weakness
A 13-month-old boy with the classic darting eye movements characteristic of opsoclonus. His subsequent diagnosis of opsoclonus myoclonus syndrome led to discovery of an occult neuroblastoma. (From Roach ES, Islam MP: Dancing hands and clumsy feet. Ped Neurol 2014; 50(5):539, with permission.)

Related to: Practical Neurology, 5e > 38: Approach to Common Emergencies in Pediatric Neurology
A 22-year-old man with history of temporal lobe seizures since age 5 and mesial temporal sclerosis.

Related to: Practical Neurology, 5e > 6: Approach to the Patient with Seizures
A 23-year-old man with history of attention deficit hyperactivity disorder had a right mesio-temporal-occipital and posterolateral thalamic infarcts with residual left homonymous hemianopia.

Related to: Practical Neurology, 5e > 40: Ischemic Cerebrovascular Disease
A 23-year-old woman, G1, P1, with longstanding history of right sided unilateral throbbing headaches, at times associated with photophobia and sonophobia, consulted for evaluation of brief stereotyped episodes of migrating numbness from the left finger tips to the elbow, associated with “clenching” and weakness of the left hand.

Related to: Practical Neurology, 5e > 54: Therapy of Migraine, Tension-Type, and Cluster Headache
A 33-year-old woman, G4, P3, 27-week pregnant with history of migraine without aura, had previous clipping of an asymptomatic left supraclinoid internal carotid artery (ICA) aneurysm, and ongoing surveillance of an asymptomatic unruptured left cavernous ICA aneurysm.

Related to: Practical Neurology, 5e > 62: Neurologic Diseases in Pregnancy
A 36-year-old woman with history of hereditary spherocytosis, system lupus erythematosus, hypercoagulable state, malignant right MCA infarction, and post-stroke seizures had a previous right hemicraniectomy.

Related to: Practical Neurology, 5e > 40: Ischemic Cerebrovascular Disease
A 41-year-old man with bilateral (left > right) cerebellar hemispheric infarctions in the distribution of the posterior inferior cerebellar artery (PICA) territory secondary to extracranial left vertebral artery dissection. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 14: Approach to the Patient with Facial Pain
A 46-year-old man with severe neurogenic claudication due to congenital lumbar canal stenosis.

Related to: Practical Neurology, 5e > 26: Approach to the Patient with Failed Back Syndrome
A 46-year-old woman with multiple sclerosis (MS) involving the spinal cord.

Related to: Practical Neurology, 5e > 50: Spinal Cord Disorders
A 48-year-old patient with thyroid myopathy. The patient has proximal and distal weakness with diffuse atrophy.

Related to: Practical Neurology, 5e > 52: Myopathy
A 49-year-old woman with a hemorrhagic presentation of Moyamoya disease who underwent left superficial temporal to middle cerebral artery anastomosis dural synangiosis, as well as myo-synangiosis.

Related to: Practical Neurology, 5e > 41: Hemorrhagic Cerebrovascular Disease
A 50-year-old woman with 6 months of fluctuating diplopia and dysphagia. Cogan lid twitch of the ptotic right upper lid when looking up. Diagnostic for MG.

Related to: Practical Neurology, 5e > 53: Disorders of the Neuromuscular Junction
A 58-year-old woman with atrial fibrillation, hypertension, dyslipidemia, and cerebral embolism with residual encephalomalacia in the left posterior temporal, parietal and occipital lobes. At initial presentation she had a Wernicke’s aphasia and a right homonymous hemianopia

Related to: Practical Neurology, 5e > 3: Approach to the Patient with Aphasia
A 70-year-old woman with rheumatoid arthritis and 1 year history of fluctuating bulbar weakness. Nasal (palatal) dysarthria typical for MG.

Related to: Practical Neurology, 5e > 53: Disorders of the Neuromuscular Junction
A 9-year -old boy with a spontaneous absence seizure, characterized by staring, with repetitive eye blinking and unresponsiveness, lasting approximately 10 seconds.

Related to: Practical Neurology, 5e > 42: Epilepsies in Children
A complete pupil-sparing third nerve palsy in a diabetic patient. Note the intorsion of the eye on attempted downgaze due to intact fourth nerve and superior oblique function.

Related to: Practical Neurology, 5e > 12: Approach to the Patient with Diplopia
A part of a video interview with Dan (see chapter case study).

Related to: Practical Neurology, 5e > 39: Approach to Ethical Issues in Neurology

Related to: Practical Neurology, 5e > 25: Approach to the Patient with Lower Extremity Pain, Paresthesias, and Entrapment Neuropathies
A patient with paramedian thalamic syndrome (infarction) with preserved horizontal eye movements to tracking and oculocephalics, reduced to absent for vertical eye movements. Also, there was bilateral asterixis.

Related to: Practical Neurology, 5e > 5: Approach to the Comatose Patient
A patient with trigeminal trophic syndrome illustrating neurotrophic ulceration in the left ala nasi area in a dermatome of the trigeminal nerve. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 13: Approach to the Patient with Facial Numbness
A short video of the neurologist’s interview with Maria, six months after the incident described in the case study.

Related to: Practical Neurology, 5e > 39: Approach to Ethical Issues in Neurology
Acute left hemispheric infarct in a patient with aortic valve surgery, prior chronic ascending aortic dissection, on warfarin therapy.

Related to: Practical Neurology, 5e > 63: The ABCs of Neurologic Emergencies
An adolescent boy with neurofibromatosis type 1 and scoliosis.

Related to: Practical Neurology, 5e > 37: Approach to Common Office Problems of Pediatric Neurology
An elderly man with prominent multifocal asterixis and myoclonus. There also appears to be an underlying tremor.

Related to: Practical Neurology, 5e > 1: Approach to the Patient with Acute Confusional State (Delirium/Encephalopathy)
An overview of headache as a presenting neurologic symptom, including characteristics of common primary headache disorders - namely tension headache, migraine, and the trigeminal autonomic cephalgias – and the importance of differentiating between primary and secondary headache disorders, clues to diagnosis, and appropriate investigative studies.

Related to: Practical Neurology, 5e > 20: Approach to the Patient with Acute Headache
AP intralaminar epidural steroid injection.

Related to: Practical Neurology, 5e > 55: Chronic Pain
Apraxia in a patient with advanced Alzheimer’s disease. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 2: Approach to the Patient with Dementia
Bilateral INO in a young patient with MS.

Related to: Practical Neurology, 5e > 44: Multiple Sclerosis
Cerebellar signs in a patient with SCA type 1. Examination demonstrates cerebellar dysarthria with dysmetria on finger-to-nose maneuver and overshooting on finger chasing task. Gait is broad-based and ataxic, and unsteady.

Related to: Practical Neurology, 5e > 29: Approach to the Ataxic Patient
Complex partial seizures.

Related to: Practical Neurology, 5e > 43: Epilepsy in Adults
Complex partial seizures.

Related to: Practical Neurology, 5e > 43: Epilepsy in Adults
Counter maneuvers in patients with symptomatic orthostatic hypotension. Various simple physical maneuvers that raise BP include leg crossing while seated or standing, squatting, arm crossing, making a fist, and muscle tensing.

Related to: Practical Neurology, 5e > 32: Approach to the Patient with Neurogenic Orthostatic Hypotension, Sexual and Urinary Dysfunction, and Other Autonomic Disorders
Cryptococcal meningitis. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 48: Neurologic Complications in Acquired Immune Deficiency Syndrome
Demonstration of Epley maneuver, a common technique used for canalith repositioning. If repositioning is difficult due to body habitus, physical deconditioning, or space/equipment limitations, referral for vestibular therapy is appropriate.

Related to: Practical Neurology, 5e > 61: Dizziness and Vertigo
Effects of spinal cord stimulation in CRPS I. The patient from Figure 56.1 with CRPS I of right upper extremity. Placement of spinal cord stimulator resulted in relief of pain,resolution of edema and erythema along with a decrease in allodynia.

Related to: Practical Neurology, 5e > 56: Complex Regional Pain Syndrome
EMG demonstration of myotonic discharges in a patient with myotonic dystrophy.

Related to: Practical Neurology, 5e > 36: Approach to the Selection of Electrodiagnostic, Cerebrospinal Fluid, and Other Ancillary Testing
Examination after an overnight withdrawal of levodopa demonstrates resting tremor, bradykinesia with decrement, hypomimia, and short shuffling gait with freezing on turning. One hour after administration of a therapeutic dose of levodopa, improvements are evident with resolution of tremor and freezing, and significant improvements in gait and speed.

Related to: Practical Neurology, 5e > 45: Movement Disorders
Example of the alternating light test performed in darkness on a patient with a small-to-moderate right RAPD.

Related to: Practical Neurology, 5e > 11: Approach to the Patient with Abnormal Pupils
Example of the alternating light test performed in room light and in darkness on a patient with a large right RAPD.

Related to: Practical Neurology, 5e > 11: Approach to the Patient with Abnormal Pupils
Fluctuating Parkinson’s disease with marked parkinsonism in the “practically defined off” period. The second segment shows patient in the “on” period, about 90 minutes after the first video was taken.

Related to: Practical Neurology, 5e > 30: Approach to the Hypokinetic Patient
Focal sensory seizures in a young patient with a brain AVM. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 27: Approach to the Patient with Acute Sensory Loss
Fragile X-associated tremor/ataxia syndrome (FXTAS). A 65-year-old man was referred because of action tremor in both hands and gait instability

Related to: Practical Neurology, 5e > 28: Approach to the Hyperkinetic Patient
Fragile X-associated tremor/ataxia syndrome (FXTAS). A 65-year-old man was referred because of action tremor in both hands and gait instability.

Related to: Practical Neurology, 5e > 28: Approach to the Hyperkinetic Patient
Fragile X-associated tremor/ataxia syndrome (FXTAS). A 65-year-old man was referred because of action tremor in both hands and gait instability.

Related to: Practical Neurology, 5e > 28: Approach to the Hyperkinetic Patient
Fragile X-associated tremor/ataxia syndrome (FXTAS). During the examination of the patient from Videos 28-1 and 28-2, wide base ataxia was clearly present with very difficult tandem gait, and a history of repeated falling during the past three months. Genetic testing showed 62 CGG repeats in the FMR1 gene.

Related to: Practical Neurology, 5e > 28: Approach to the Hyperkinetic Patient
Huntington’s disease. A 63-year-old woman was referred because of gait instability. At rest, distal and mild athetotic moviments could be observed in both feet and hands, as well as facial choreic moviments.

Related to: Practical Neurology, 5e > 28: Approach to the Hyperkinetic Patient
Huntington’s disease. Examination of muscle stretch reflexes elicited hung-up reflexes in the right leg. Genetic testing showed 43 CAG repeats in the HD gene.

Related to: Practical Neurology, 5e > 28: Approach to the Hyperkinetic Patient
Huntington’s disease. Gait ataxia was evident, with very unstable tandem gait.

Related to: Practical Neurology, 5e > 28: Approach to the Hyperkinetic Patient
Huntington’s disease. patient’s disability.

Related to: Practical Neurology, 5e > 28: Approach to the Hyperkinetic Patient
In this video examples are given of tests in the physical examination of the patient that can contribute to the diagnosis of a functional neurological disorder.

Related to: Practical Neurology, 5e > 33: Approach to the Patient with Functional Disorders in the Neurology Clinic
L4-5 transforaminal epidural injection.

Related to: Practical Neurology, 5e > 55: Chronic Pain
Left-sided V2 maxillary nerve block.

Related to: Practical Neurology, 5e > 55: Chronic Pain
Meningeal signs.

Related to: Practical Neurology, 5e > 47: Central Nervous System Infections
Migraine aura is most commonly visual and binocular, involving both positive and negative visual phenomena. The symptoms evolve typically over a duration of 5-60 minutes and are present with eyes both open and closed. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 21: Approach to the Patient with Chronic and Recurrent Headache
Myoclonic seizures.

Related to: Practical Neurology, 5e > 43: Epilepsy in Adults

Related to: Practical Neurology, 5e > 42: Epilepsies in Children
Myoclonus is a common phenomenon in late Alzheimer's disease and can be of both cortical and subcortical origin. Increased excitability of the cortex is due to loss of inhibitory influences. In extremis the hyperexcitability can lead to seizures. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 46: Dementia
Neurologic evaluation of a patient with a C6 radiculopathy.

Related to: Practical Neurology, 5e > 22: Approach to the Patient with Neck Pain and/or Arm Pain
Neurometabolic disorder overview.

Related to: Practical Neurology, 5e > 49: Inherited Metabolic Neurologic Disorders
Postoperative left femoral neuropathy in a 49-year-old woman. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 27: Approach to the Patient with Acute Sensory Loss
REM sleep behavior disorder (RBD), a rapid eye movement (REM) parasomnias, is increasingly recognized as a marker of an evolving neurodegenerative disease. Patients with RBD may experience nocturnal behaviors that may contribute to injury of the patient and bed partner.

Related to: Practical Neurology, 5e > 60: Sleep Disorders
Right-sided stellate ganglion block.

Related to: Practical Neurology, 5e > 55: Chronic Pain
Scapular winging due to a prior long thoracic nerve injury.

Related to: Practical Neurology, 5e > 51: Peripheral Neuropathy
Spastic dysarthria in a patient with arterial hypertension, diabetes and dyslipidemia, with multiple previous pontine infarction and recent right medial medullary infarction.

Related to: Practical Neurology, 5e > 19: Approach to the Patient with Dysarthria
Spastic right hemiparetic gait in a young patient with left cervical internal carotid artery dissection. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 8: Approach to the Patient with Gait Disturbance and Recurrent Falls
Subtle myokymia is noted in the foot and calf. It is more pronounced in the periorbital region. (From Lukas RV, Rezania K, Malec M, Salgia R. Teaching Video NeuroImages: myokymia and nerve hyperexcitability as components of Morvan syndrome due to malignant thymoma. Neurology. 2013;80(5):e55.)

Related to: Practical Neurology, 5e > 58: Nervous System Complications of Cancer
Sudden onset of right hearing loss and tinnitus suspected secondary to barotrauma. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 18: Approach to the Patient with Dysphagia
Summary of teaching points.

Related to: Practical Neurology, 5e > 62: Neurologic Diseases in Pregnancy
Sustained, self-induced clonus of the lower extremities in a patient with serotonin syndrome.

Related to: Practical Neurology, 5e > 59: Neurotoxicology
Symptom Media: Alcohol Use Disorder

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Autism Spectrum Disorder, Core Video

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Autism Spectrum Disorder, Mild

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Autism Spectrum Disorder, Moderate

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Autism Spectrum Disorder, Severe

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Bipolar I Disorder with Mood-Congruent Psychotic Features

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Bipolar I Disorder with Mood-Congruent Psychotic Features After Treatment

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Generalized Anxiety Disorder

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Greg, Core Video: Cannabis Use Disorder, Moderate, Part 1

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Greg, Core Video: Cannabis Use Disorder, Moderate, Part 2

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Greg, Core Video: Cannabis Use Disorder, Moderate, Part 3

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Greg, Core Video: Cannabis Use Disorder, Moderate; Somatic Symptom Disorder, Part 4

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Major Depressive Disorder with Anxious Distress

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Major Depressive Disorder with Melancholic Features

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Major Depressive Disorder with Peripartum Onset

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Major Depressive Disorder with Seasonal Pattern

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mental Status Exam B-1

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mental Status Exam B-2

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mental Status Exam B-3

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mental Status Exam B-4

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mental Status Exam B-5

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mental Status Exam B-6

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mr. Smith, Catatonia Associated with Schizophrenia, Part 1

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mr. Smith, Catatonia Associated with Schizophrenia, Part 2

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mr. Smith, Catatonia Associated with Schizophrenia, Part 3

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mr. Smith, Catatonia Associated with Schizophrenia, Part 4

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mr. Smith, Catatonia Associated with Schizophrenia, Part 5

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mr. Smith, Catatonia Associated with Schizophrenia, Part 6: Echolalia

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Mr. Smith, Catatonia Associated with Schizophrenia, Part 7: Echopraxia and Echolalia

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Not on the Autism Spectrum

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Obsessive Compulsive Personality Disorder

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Opioid Use Disorder, moderate

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Opioid Use Disorder, severe

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Shannon, Opioid Use Disorder

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Stimulant Use Disorder, moderate, cocaine

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Suicide Assessment A-1

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Suicide Assessment A-3

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Suicide Assessment A-4

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Suicide Assessment A-5

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Suicide Assessment A-5

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
Symptom Media: Suicide Assessment A-6

Related to: Kaplan & Sadock's Synopsis of Psychiatry, 12e
The “swinging flashlight test” demonstrates a relative afferent pupillary defect in the left eye. Note the lack of a brisk pupillary contraction (and even dilation) when the light is shined in the left eye, compared to the right.

Related to: Practical Neurology, 5e > 10: Approach to the Patient with Visual Loss
The classical elements of the sleep-related rhythmic movement disorder (body rocking, head banging, and leg banging with rhythmic vocalizations during N2 sleep) in a young girl suspected of having nocturnal seizures.

Related to: Practical Neurology, 5e > 9: Approach to the Patient with Sleep Disorders
The clock drawing test is an excellent test to discern the degree of cognitive impairment as it can give information regarding multiple cognitive domains. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 46: Dementia
The patient had a left iatrogenic peripheral facial nerve injury due to cholesteatoma removal six months earlier; status post facial nerve grafting.

Related to: Practical Neurology, 5e > 15: Approach to the Patient with Facial Weakness
The proper evaluation of syncope requires knowledge of its causes, and an understanding that while cardiovascular causes are most common, they may be difficult to diagnose.

Related to: Practical Neurology, 5e > 7: Approach to the Patient with Syncope
This video highlights updates to the chapter Approaching a Patient with Memory Impairments, including the use of DSM-5 criteria with memory impairments.

Related to: Practical Neurology, 5e > 4: Approach to the Patient with Memory Impairment
Torsional nystagmus from left benign paroxysmal positional vertigo, from the posterior canal. (Courtesy of Timothy C. Hain.)

Related to: Practical Neurology, 5e > 16: Approach to the Patient with Dizziness and Vertigo
Triple flexion spinal reflex; seen with nailbed compression in brain death.

Related to: Practical Neurology, 5e > 34: Approach to the Patient with Suspected Brain Death
Ultrasound of the median nerve at the wrist in a normal individual. The cross-sectional area (CSA) is measured by tracing the outline of the median nerve with the ultrasound machine. The upper limit of normal CSA for the median nerve at the wrist is 10 mm2 (or 0.1 cm2).

Related to: Practical Neurology, 5e > 24: Approach to the Patient with Upper Extremity Pain and Paresthesias and Entrapment Neuropathies
Very strong left-beating nystagmus from lateral canal positional vertigo (head left position). (Courtesy of Dizziness Solutions.)

Related to: Practical Neurology, 5e > 16: Approach to the Patient with Dizziness and Vertigo
Video 17-1. Sudden onset of right hearing loss and tinnitus suspected secondary to barotrauma. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 17: Approach to the Patient with Hearing Loss
Video 25-1. Common peroneal neuropathy at the fibular head. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 25: Approach to the Patient with Lower Extremity Pain, Paresthesias, and Entrapment Neuropathies
Video 35-1. A young male status post severe traumatic brain injury. CT demonstrates bifrontal encephalomalacia and ventriculomegaly. MRI demonstrates bifrontal encephalomalacia and cortical and cerebellar volume loss. (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 35: Neuroimaging of Common Neurologic Conditions
Video of a patient describing the history of the symptoms of neurogenic claudication from lumbar stenosis.

Related to: Practical Neurology, 5e > 23: Approach to the Patient with Low Back Pain, Lumbosacral Radiculopathy, and Lumbar Stenosis
WHO Grade 1 myxopapillary ependymoma of the conus medullaris (Courtesy of José Biller, MD.)

Related to: Practical Neurology, 5e > 57: Primary Central Nervous System Tumors

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