Key presentations and conditions
Basic Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Presentations
- Gait and balance disturbances
- Headache and facial pain
- Hearing loss
- Memory disturbances
- Neuropathic pain
- Numbness or altered sensation
- Seizures:
- absence
- afebrile
- febrile
- focal
- generalised tonic–clonic
- myoclonic
- non-convulsive status epilepticus
- status epilepticus
- Syncope
- Visual disturbance or abnormal eye movement
- Weakness
Conditions
- Bell’s palsy and other cranial nerve lesions, including trigeminal neuralgia
- Cerebellar disorders
- Cerebral neoplasia
- Dementia syndromes
- Epilepsy
- Gait disorders
- Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP)
- Meningitis and encephalitis
- Migraine and common headache disorders
- Mononeuropathies, common
- Multiple sclerosis
- Neurological manifestations of systemic and chronic disease, such as paraneoplastic disorders
- Ophthalmalogical conditions:
- Horner syndrome
- nystagmus
- optic neuritis
- papilloedema
- Parkinson disease and related conditions, such as:
- corticobasal degeneration
- multiple systems atrophy
- progressive supranuclear palsy
- Peripheral neuropathy:
- acquired
- hereditary
- Spinal cord and nerve root compression
- Stroke, haemorrhagic and ischaemic, and transient ischaemic attack (TIA)
- Tremor
- Vertigo
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients1 and their quality of life
Manage
- provide evidence-based management
For less common or more complex presentations and conditions the trainee must also seek expert opinions - prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Less common or more complex presentations and conditions
Basic Trainees will understand these presentations and conditions. Basic Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Conditions
- Cerebral venous sinus thrombosis
- Genetic neurological disorders, such as Huntington disease and myotonic dystrophy
- Idiopathic intracranial hypertension
- Limbic encephalitis
- Motor neurone disease
- Myasthenia gravis
- Myopathy, acquired and genetic
- Normal pressure hydrocephalus
- Psychogenic neurological disorders
- Unusual stroke syndrome
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients1 and their quality of life
Manage
- provide evidence-based management
For less common or more complex presentations and conditions the trainee must also seek expert opinions - prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Epidemiology, pathophysiology and clinical sciences
Basic Trainees will describe the principles of the foundational sciences.
- Action of neurotransmitters and neurotransmission
- Concept of ‘brain death’
- Electrical activity of the brain and nerve conduction
- Embryology, anatomy, and neuroanatomy of the visual system
- Indication for and application of thrombolysis
- Metabolism of the brain
- Neuroanatomy of the nervous system, including recognition of the functionality of different areas of the brain
- Pharmacology of major neurological drugs
- Physiology of vision and hearing
- Sleep-wake regulation
Investigations, procedures and clinical assessment tools
Basic Trainees will know the indications for, and how to interpret the results of these investigations, procedures, and clinical assessments tools. Basic Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Investigations
- Audiometry
- CT and MRI brain imaging, including CT angiography and CT perfusion
- Lumbar puncture and cerebrospinal fluid (CSF) analysis
- Neurophysiological studies:
- electroencephalography (EEG)
- electromyography (EMG)
- nerve conduction studies (NCS)
Clinical assessment tools
- Cognitive or brain functionality assessment
- Extraocular movements
- Fundoscopy
- Vision testing, such as visual acuity and colour vision testing
Important specific issues
Basic Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
- Restrictions on driving following neurological illness, as identified by the statutory body
- Safety considerations as a consequence of neurological disorders, such as epilepsy in relation to scuba diving
- References to patients in the remainder of this document may include their families or carers.