Veidlapa Nr. M-3 (8)
Study Course Description
Neurology and Neurosurgery
Course Code
NUNK_022
Branch of Science
Clinical medicine; Neurology
ECTS
7.00
Target Audience
Medicine
LQF
Level 7
Study Type And Form
Full-Time
Study Course Implementer
Course Supervisor
Daina Pastare
Structure Unit Manager
Guntis Karelis
Structural Unit
Department of Neurology and Neurosurgery
Contacts
Riga, 13 Pilsoņu Street, VSIA P.Stradiņa KUS, block No 37; 2 Hipokrata Street, department No 7, room No. 901, neuro@rsu.lv, +371 67069653; +371 67536540
About Study Course
Objective
To promote mastering of knowledge of a topical diagnosis in neurology, neurological examination, as well as mastering of knowledge of pathogenesis, clinical manifestations and treatment of nervous system diseases.
Preliminary Knowledge
Preclinical theoretical knowledge of the anatomy and physiology of the nervous system (disciplines of the 1st and 2nd year of study).
Learning Outcomes
Knowledge
1.As a result of completing the study course, the student is able to communicate how to evaluate the neurological and neurosurgical patient, describe various neurological syndromes and their differential diagnosis.
2.Will be able to list and describe pathogenesis, clinical manifestations of the most common neurological diseases, as well as describe and justify the selection of investigative methods and therapies.
Skills
1.After completing the study course, the student will be able to: develop an examination and treatment plan for neurological and neurosurgical syndromes and symptoms; apply knowledge in topical diagnostics to specify the site of damage in the nervous system; formulate a neurological diagnosis; explain the chosen treatment method and its application; predict the possible course of the disease and the outcome of the therapy; navigate the latest international advances in neurologists and neurosurgeons.
2.By the end of the course, the student will have acquired the following skills: engine system investigation: assessment of the muscle strength of the upper limbs; assessment of the muscle strength of the lower limbs; examination of muscle tone in arms and legs; pronation test; a silent check; abnormal reflexes in the legs; assessment of tendon reflexes; differentiating between spasticity and rigidity. Checking for meningeal symptoms. Sensory system examination and interpretation of results: superficial sensing test; sensory attention test; sensing interference level detection; deep sensing test. Cranial nerve investigation: assessment of visual acuity; field of vision examination; pupils’ reaction to light; evaluation of eyeballs movements; face sensing test; verification of the strength of the mimic muscle; examination of the palate reflex; checking the muscle strength of the neck and shoulder band. Identification of cranial disorders: nistagm; ocular movement disorders; n. facialis neuropathy; motor speech disorders; Horner syndrome. Identifying symptoms of cortical damage: aphasia; crying under duress; symptoms of denial. Examination of the extrapyramidal system and interpretation of the results: symptoms of parkinsonism; hyperkinesis, etc. Brain examination and interpretation of results. Evaluation of gait and balance. Checks on movement coordination in arms and legs. Testing of small motor vehicles. Peripheral nerve examination. Assessment of clinical signs of stroke (NIHSS scale) and interpretation of results. Additional investigative methods: electroencephalography; neurography/electromyography; polysomnography. Assess the patient’s condition on the Glasgow coma scale. Draw up an examination and treatment plan for a patient with a head injury based on clinical and radiological findings. Assess patient status on the Hunt-Hess scale. Draw up an examination and treatment plan for a patient with spontaneous subarachnoidal haemorrhage based on clinical and radiological findings. Assess general and specific clinical symptoms in a patient with a CNS tumor. Evaluate a patient with a CNS tumor on Karnofsky and ECOG scales.
Competences
1.As a result of successful completion of the study course, the student is able to recognise the symptoms of the most common neurological and neurosurgical diseases.
2.To argue and rationalise the neurological diagnosis.
3.Develop a tactic suitable for a specific neurological clinical situation to optimally diagnose and treat a neurological condition.
Assessment
Individual work
|
Title
|
% from total grade
|
Grade
|
|---|---|---|
|
1.
Patient assessment |
-
|
-
|
|
Assess and interpret the condition of the neurological and neurosurgical patient. |
||
|
2.
Preparing for classes |
-
|
-
|
|
Prepare for practice in theory. |
||
|
3.
Studying literature |
-
|
-
|
|
To work independently with literature in neurology. |
||
Examination
|
Title
|
% from total grade
|
Grade
|
|---|---|---|
|
1.
Motivation and activity |
-
|
-
|
|
Active participation in classes, quality of oral responses, participation in discussions. |
||
|
2.
Practical neurology |
-
|
-
|
|
Skills for neurological examination, interpretation of symptoms. |
||
|
3.
Theoretical fitness |
-
|
10 points
|
|
Quality of test work during the cycle on the topics covered. |
||
|
4.
Exam |
-
|
10 points
|
|
Test method: Oral and written exam in 5th year of study – students knowledge of topical diagnosis in neurology, neurological lesion syndromes, etiology of nervous system diseases and neurosurgical diseases, pathogenesis, clinics, diagnostics, principles and prevention of treatment are examined. |
||
Study Course Theme Plan
FULL-TIME
Part 1
-
Video Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Study room
|
2
|
Topics
|
Introduction. Additional examinations in neurology. Functional disorders of the autonomic nervous system. Somatoform and dissociative disorders.
|
-
Video Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Study room
|
2
|
Topics
|
Cerebrovascular diseases.
Transient ischaemic attack. Ischaemic stroke. Subarachnoid haemorrhage. Intracerebral haemorrhage. Pathogenesis and risk factors of cerebrovascular diseases. Treatment of cerebrovascular diseases.
|
-
Video Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Study room
|
2
|
Topics
|
Neuroinfections. Bacterial meningitis. Aseptic (viral) meningitis. Neuroborreliosis. Tick-borne encephalitis. Herpes simplex encephalitis.
|
-
Video Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Study room
|
2
|
Topics
|
Epilepsy. Status epilepticus. Glasgow coma scale. Differential diagnosis of coma.
|
-
Video Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Study room
|
2
|
Topics
|
Functional disorders of the peripheral nervous system. Polyneuropathies. Guillain-Barré syndrome.
|
-
Video Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Study room
|
2
|
Topics
|
Cognitive deficit and dementias. Transient global amnesia.
|
-
Video Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Study room
|
2
|
Topics
|
Myasthenia gravis. Myasthenic syndromes. Muscle diseases.
|
-
Video Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Study room
|
2
|
Topics
|
Back pain. Non-specific, specific back pain. Radiculopathies. Myelopathies.
|
-
Video Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Study room
|
2
|
Topics
|
Autoimmune and paraneuroplastic neurological syndromes.
|
-
Video Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Study room
|
2
|
Topics
|
Pathogenesis and differential diagnosis of vertigo syndrome.
|
-
Video Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Study room
|
2
|
Topics
|
Head injury. Hydrocephalus.
|
-
Video Lecture
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Study room
|
2
|
Topics
|
Neurooncology. Brain tumours. Surgical treatment of cerebrovascular diseases.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Examination of neurological condition.
Simplified testing of cognitive condition.
Neurological terminology.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Central and peripheral palsies. Central motor neuron. Peripheral motor neuron. Palsy of central and peripheral mimic muscles. Reflex arc. Examination of the sphere of movements.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Types of sensibility. Sensory conduction systems (pathways): superficial and deep sensory conduction systems. Types of sensibility disorders. Types of spinal cord injuries. Complete or incomplete transverse injury of the spinal cord. Cauda equina syndrome.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Cranial nerves. Symptoms of injury of cranial nerves and the brainstem, their examination. Bulbar and pseudobulbar syndrome. Consensual eye movement regulation. Conjugate gaze palsies. Vestibular syndrome.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Types of aphasia. Motor, sensory, Wernicke's, Broca’s, conduction, transcortical, amnestic aphasia. Clinical and Boston classification. Agnosia, apraxia, denial syndrome. Symptoms of the frontal lobe injury. Symptoms of the parietal lobe injury. Symptoms of the temporal lobe injury. Symptoms of the occipital lobe injury.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Movement disorders. Extrapyramidal system and its lesion syndromes. Hyperkinesis, Parkinson’s syndrome and Parkinson’s disease.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Symptoms of cerebellar injury and its clinical examination.
Gait disorders.
Types of ataxia.
Differential diagnostics of vertigo syndrome.
Knowledge test. Topical diagnostics.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Aetiology and clinical manifestations of plexus brachialis injury syndromes. Neuropathies in the upper extremity and their most common aetiology: Injury of n.medianus. Injury of n.ulnaris. Injury of n.radialis. Aetiology and clinical manifestations of plexus lumbosacralis injury syndromes. Neuropathies in the lower extremity and their most common aetiology: Injury of n.ishiadicus. Injury of n.femoralis. Injury of n.peroneus. Injury of n.tibialis.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Additional examination methods in neurology.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Cerebrovascular diseases. Transient ischaemic attack. Ischaemic stroke. NIHSS, Rankin scale. TOAST classification. Exclusion syndromes of different arteries – ACI, ACM, ACA, AChA, ACP, AB, AB branches, cerebellar arteries. Revascularisation treatment in patients with acute ischemic stroke. Secondary prevention principles. CHA2DS2-Vasc and HAS-BLED scales.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Haemorrhagic stroke. Intracerebral haematoma. Subarachnoid haemorrhage. Risk factors, aetiology, pathogenesis and treatment. Spinal infarction and spinal non-traumatic haemorrhage. Clinical picture and treatment principles.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Headache. International classification of headaches (ICHD-3). Migraine. Tension headache. Trigeminal autonomic cephalalgia. Painful cranial neuropathies. Secondary headaches.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Epilepsy. Differential diagnosis of paroxysmal conditions. Syncope.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Acute disseminated encephalomyelitis. Diseases of the neuromyelitis optica spectrum. Multiple sclerosis. McDonald criteria. Diseases of motor neurons.
Knowledge test. Neurological diseases.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Skull fractures. Severe head injury, its treatment principles.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
CNS tumours, treatment tactics.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Surgical treatment of cerebrovascular diseases.
|
-
Class/Seminar
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
3
|
Topics
|
Degenerative muscle diseases. Hydrocephalus.
|
-
Test
|
Modality
|
Location
|
Contact hours
|
|---|---|---|
|
On site
|
Specialized room
|
2
|
Topics
|
Solution of case studies and situations. Neurological examination and interpretation of results. Knowledge test at the end of the course.
|
Total ECTS (Creditpoints):
7.00
Contact hours:
78 Academic Hours
Final Examination:
Exam
Bibliography
Required Reading
1.
Fuller G. Neurological Examination Made Easy,.Ch. Livingstone, Elsevier, 2020.Suitable for English stream
2.
Adams R.D., Victor M. Adams and Victor's principles of neurology / Allan H. Ropper, Martin A. Samuels. Mc Graw – Hill, N-Y, St Luis e.c. 2019.Suitable for English stream
3.
R.B. Daroff, J.Jankovic, J.C Mazziotta, S.L Pomeroy. Bradley and Daroff's Neurology in Clinical Practice. 8th Edition, 2022.Suitable for English stream
4.
H. Royden Jones Jr., Jayashri Srinivasan, Gregory J. Allam and Richard A. Bake. Netter's Neurology. Elsevier, 3rd edition, 2019.Suitable for English stream
Additional Reading
1.
M.J. Aminoff, D. Greenberg, R.P. Simon. Clinical Neurology. 11st edition, Mc Graw-Hill Education Lange, 2021.Suitable for English stream
2.
Current Diagnosis and treatment Neurology. McGrawHill, 3rd edition, 2019.Suitable for English stream
3.
J.Bērziņš, I.Logina, M.Pilmane, E.Vītols. Neiromuskulārās slimības. Nacionālais apgāds, 2007. (attiecas uz LV plūsmas studijām)
4.
Gārša I. Ievads neiroķirurģijā. Nac. medicīnas apgāds, 2000, 2008. (attiecas uz LV plūsmas studijām)
Other Information Sources
1.
MedscapeSuitable for English stream