The Neurology of the Elderly

1 The Neurological Examination of The Elderly Patient.- History-taking.- The General Examination.- Temperature.- Blood Pressure.- Aids, Appliances and Chairs.- The Neurological Examination.- 2 The Investigation of the Elderly Patient.- Lumbar Puncture.- Computed Tomography (CT) Scan.- Electroencephalography (EEG).- Electromyography (EMG) and Nerve Conduction Velocity (NCV).- Evoked Potential Recording.- Myelography.- Angiography.- Magnetic Resonance Imaging (MRI).- 3 "Confusion" and Dementia.- History.- Examination.- Tests of Memory.- Tests of Language Function.- Visuo-spatial Disorientation.- Physical Examination.- Acute and Subacute Organic Brain Syndromes.- Confusional States due to Drugs.- Nocturnal Behavioural Disturbance.- Nutritional and Toxic Confusional States.- Dementia: Chronic Organic Brain Syndromes.- Senile Dementia of the Alzheimer Type (SDAT).- The Vascular (Arteriosclerotic or Multi-infarct) Dementias.- "Reversible Dementias".- Subcortical Dementia.- Parkinson's Disease and Dementia.- Dementia of Frontal Type.- Normal Pressure Hydrocephalus.- Pseudodementia.- 4 Disturbances of Gait and Balance, and Falls.- Maintenance of Posture and the Effects of Age and Age-related Disease.- Sensory.- Motor.- Musculo-skeletal Changes.- Neuropathies.- Subacute Combined Degeneration of the Cord.- Gait Dyspraxia.- Treatment.- 5 Headache and Facial Neuralgia.- Headache.- Extracranial Headache.- Intracranial Headache.- Psychogenic Headache.- Facial Neuralgia.- Trigeminal Neuralgia.- Post-herpetic Neuralgia.- Migrainous Syndromes.- Atypical Facial Pain.- 6 Some Visual Problems.- Episodic Visual Disturbance.- Amaurosis fugax.- Migraine.- Epilepsy.- Persistent and Progressive Visual Disturbance.- Prechiasmal (and Retrobulbar) Lesions.- Retrochiasmal Lesions.- Double Vision.- Visual Hallucinations and Disorders of Visual Perception.- 7 Incontinence.- Urinary Incontinence.- Normal Control of the Bladder.- The Effect of Ageing.- History of Urinary Incontinence.- Examination and Investigation.- The Causes of Urinary Incontinence.- Faecal Incontinence.- Normal Control of Defaecation.- History of Faecal Incontinence.- Examination.- Conclusion.- 8 Parkinsonism and Abnormal Movement Disorders.- The Presenting Symptoms and Signs of Parkinsonism.- The Examination of the Patient with Parkinsonism.- The Tremor.- Hypokinesia.- Rigidity.- Other Signs in Parkinsonism.- Disorders of Gait.- Disorders of Higher Mental Function.- Autonomic Function.- Eye Signs.- Assessment.- Course.- Parkinson's Disease and Senile Parkinsonism.- Management.- Abnormal Movement Disorders: Dystonias.- Dystonia.- Facial Dyskinesia.- Dystonic Dysarthria.- 9 Attacks of Loss of Consciousness and Disturbance of Memory.- Attacks of Loss of Consciousness.- History, Examination and Investigation.- Epilepsy.- Cardiac Dysrrhythmias.- Postural Hypotension.- Cough and Micturition Syncope.- "Drop Attacks".- Vertebro-basilar Ischaemia.- Post-stroke "Narcolepsy" and Drowsiness.- Hypothermia.- Amnesic States.- Wernicke's Encephalopathy and Korsakoff's Psychosis.- Transient Global Amnesia.- Amnesia in Diffuse Cerebral Disorder.- 10 Loss of Use in the Upper Limb.- The History.- The Examination.- The Signs.- "Numbness".- Abnormal Involuntary Movements.- Tremor.- Choreo-athetosis.- Dystonia.- Dyspraxia.- 11 Neurological Presentations of General Medical Disorders.- Diabetesm Mellitus.- Hypoglycaemia.- Thyroid Disease.- Disorders of Water and Mineral Metabolism.- Disorders of Calcium Metabolism.- Alcohol and Alcoholism.- Nutritional and other Vitamin Deficiencies.- Neuropsychiatric Manifestations of Malignant Disease.- Herpes Zoster.- Myeloma and Dysproteinaemias.- Drugs.- References and Further Reading.